title: Use of extracorporeal life support in adults with severe acute respiratory failure.
abstract: Extracorporeal membrane oxygenation (ECMO) is a recognized and accepted therapeutic option in the treatment of neonatal and pediatric respiratory failure. However, early studies in adults did not demonstrate a survival benefit associated with the utilization of ECMO for severe acute respiratory failure. Despite this historical lack of benefit, use of ECMO in adult patients has seen a recent resurgence. Local successes and a recently published randomized trial have both demonstrated promising results in an adult population with high baseline mortality and limited therapeutic options. This article will review the history of ECMO use for respiratory failure; investigate the driving forces behind the latest surge in interest in ECMO for adults with refractory severe acute respiratory failure; and describe potential applications of ECMO that will likely increase in the near future.
authors.affiliation: Duke University Medical Center, Division of Pediatric Critical Care Medicine, Durham, NC, USA. kyle.rehder@duke.edu
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Rehder
authors.forename: David A
authors.initials: DA
authors.lastname: Turner
authors.forename: Ira M
authors.initials: IM
authors.lastname: Cheifetz
mesh_terms: D000208:Acute Disease; D000328:Adult; D019317:Evidence-Based Medicine; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000266:history / Q000401:mortality; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity; D007251:Influenza, Human / Q000150:complications / Q000821:virology; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000628:therapy* / Q000821:virology; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome