Extracorporeal life support: present status and the future.
Extracorporeal life support (ECLS), which is prolonged cardiopulmonary bypass with an artificial membrane lung, is one of the most efficient life support means for patients with severe cardiopulmonary failure. Its practice will become much simpler, safer and popular in the near future. In this article, the history of ECLS and the acronyms related to it, together with its present status in the world are introduced. Also mentioned are the various methods of ECLS. Heparin-bonded hollow-fibre lungs made of non-microporous membrane are recommended for prolonged cardiopulmonary bypass to prevent gas embolism and fluid leakage from the artificial lungs. Several special clinical cases where patients were saved from moribund cardiopulmonary failure, such as severe barotrauma after excessive ventilator therapy and prolonged cardiac standstill after myocardial infarction, are described to explain the life-support effects and indications of ECLS. Research on ECLS, now taking place, such as the use of an intravenacaval oxygenator, manually operated cardiopulmonary bypass system for emergency resuscitation and transportation of the patient, as well as respiratory care of a premature newborn in artificial amnion fluid, is also introduced.
Terasaki
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Department of Anesthesiology, Kumamoto University School of Medicine, Japan.
Morioka
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass / Q000379:methods / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000639:trends*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008020:Life Support Care / Q000379:methods / Q000639:trends*; D008297:Male; D008875:Middle Aged