Critical care organ support: a focus on extracorporeal systems.
OBJECTIVE
An extensive search of the literature published in the past 2 years related to critical care organ support was undertaken. This review is limited to those that focus on extracorporeal life support modalities for adults.


RESULTS
Traditional indications for extracorporeal life support such as oxygenation, carbon dioxide exchange and support of perfusion have expanded to include solute and toxin clearance for kidney, liver and potentially neurological failure. Enhanced understanding of cell-mediated mechanisms of injury may explain multiple-organ dysfunction following single-organ damage. Extracorporeal life support systems can be used safely in patients with traumatic brain, chest, and abdominal injury. 'Emergency perfusion and resuscitation' following traumatic exsanguination is entering clinical trials.


CONCLUSIONS
Multiple-organ dysfunction followed by traumatic injury can be treated with multiple-organ support. A total extracorporeal organ support system may be used in the future as a portable, bedside organ support device.
McCunn
Maureen
M
Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. mccunnm@uphs.upenn.edu
Reed
Amy J
AJ
D003422:Critical Care; D005112:Extracorporeal Circulation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000517:prevention & control*; D017582:Renal Replacement Therapy; D014947:Wounds and Injuries / Q000628:therapy