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Extracorporeal Life Support for Adults

Part of the Respiratory Medicine Book Series (volume 16)

Editors: Schmidt, Gregory A

DOI: 10.1007/978-1-4939-3005-0

ISBN: 978-1-4939-3004-3

Publisher: Springer New York - Springer Journals

May 30, 2015

1 - 10 of 14 Chapters

LitStream

Chapter 1Physiology of Extracorporeal Life Support (ECLS)

Brain, Matthew J.; Butt, Warwick W.; MacLaren, Graeme

Pages: 1 –60

[Extracorporeal life support (ECLS) describes several advancing technologies of broadening scope that support severe cardiorespiratory dysfunction in critically ill patients. ECLS provides alternatives when mechanical ventilation does not suffice to deliver adequate oxygenation or carbon dioxide...
LitStream

Chapter 2Hypoxemic Respiratory Failure: Evidence, Indications, and Exclusions

Abrams, Darryl; Bacchetta, Matthew; Brodie, Daniel

Pages: 61 –72

[ECMO is increasingly being used to manage severe ARDS with refractory hypoxemia and hypercapnia, and to facilitate lung-protective ventilation and minimize ventilator-associated lung injury. However, there is limited high-level evidence to support its use. Early randomized trials did not show a...
LitStream

Chapter 3Cardiogenic Shock: Evidence, Indications, and Exclusions

Bréchot, Nicolas; Combes, Alain

Pages: 73 –85

[Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) can support both gas exchange and the circulation, making it suitable for treatment of patients with cardiogenic shock, refractory cardiac arrest, acute right ventricular failure, and other causes of shock. VA-ECMO has several...
LitStream

Chapter 4ECCO2R in Obstructive Diseases: Evidence, Indications, and Exclusions

Del Sorbo, Lorenzo; Ranieri, V. Marco

Pages: 87 –103

[Extracorporeal carbon dioxide removal (ECCO2R) utilizes the fact that it is simpler to clear the blood of CO2 than to oxygenate it. The entire metabolic production of CO2 can often be removed with relatively low blood flows, and accordingly smaller cannulas and simpler equipment. In ARDS, when...
LitStream

Chapter 5ECLS as a Bridge to Lung Transplantation

Kuehn, Christian

Pages: 105 –115

[Extracorporeal life support (ECLS) brings several advantages to patients awaiting lung transplantation or recovering from the operation. First, it can serve as a bridge to transplantation, supporting organ function and, at times, obviating the need for mechanical ventilation. By helping to keep...
LitStream

Chapter 6Modes of ECLS

Scott, L. Keith; Schmidt, Benjamin

Pages: 117 –131

[The two basic types of extracorporeal life support (ECLS) used commonly for adults are venovenous (VV) ECLS, typically for patients with severe acute respiratory distress syndrome (ARDS), and venoarterial (VA) ECLS, applied when circulatory as well as respiratory support is required. Each has...
LitStream

Chapter 7Vascular Access for ECLS

Conrad, Steven A.

Pages: 133 –146

[Cannulation is one of the more critical aspects of extracorporeal support. It entails the most risk, both at cannulation as well as for the duration of support. It is the most flow-limiting segment of the extracorporeal circuit, and requires careful planning and adequate sized cannulae for...
LitStream

Chapter 8Circuits, Membranes, and Pumps

Rosen, Bradley H.

Pages: 147 –161

[The ECLS circuit is composed of a variety of specialized devices that need to function separately and in concert to support the patient. As each case and patient will demand different solutions, circuits vary in their features. This chapter provides a fund of knowledge regarding these...
LitStream

Chapter 9Ventilator Management During ECLS

Pesenti, Antonio; Bellani, Giacomo; Grasselli, Giacomo; Mauri, Tommaso

Pages: 163 –180

[Modern ECLS circuits have become so efficient as to greatly supplant, or even replace, the role of the ventilator in the patient with lung failure. If the metabolic demand for oxygen can be met extracorporeally, there is less need for potentially harmful levels of PEEP and fractions of inspired...
LitStream

Chapter 10Daily Care on ECLS

Peek, Giles J.

Pages: 181 –191

[Care of the patient on ECLS requires attention to the complex circuit and a complicated patient. A systematic, daily approach is essential for safety and depends on highly experienced, diligent staff (Butt et al., Pediatr Crit Care Med 14(5 Suppl 1):S13–19, 2013). This chapter presents a...

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