title: Extracorporeal life support for adults with severe acute respiratory failure.
abstract: Extracorporeal life support (ECLS) is an artificial means of maintaining adequate oxygenation and carbon dioxide elimination to enable injured lungs to recover from underlying disease. Technological advances have made ECLS devices smaller, less invasive, and easier to use. ECLS might, therefore, represent an important step towards improved management and outcomes of patients with acute respiratory distress syndrome. Nevertheless, rigorous evidence of the ability of ECLS to improve short-term and long-term outcomes is needed before it can be widely implemented. Moreover, how to select patients and the timing and indications for ECLS in severe acute respiratory distress syndrome remain unclear. We describe the physiological principles, the putative risks and benefits, and the clinical evidence supporting the use of ECLS in patients with acute respiratory distress syndrome. Additionally, we discuss controversies and future directions, such as novel technologies and indications, mechanical ventilation of the native lung during ECLS, and ethics considerations.
authors: Extracorporeal Life Support (ECLS) Program, University Health Network, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
authors: Lorenzo
authors: L
authors: Del Sorbo
authors: Extracorporeal Life Support (ECLS) Program, University Health Network, Toronto, ON, Canada; Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors: Marcelo
authors: M
authors: Cypel
authors: Extracorporeal Life Support (ECLS) Program, University Health Network, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: eddy.fan@uhn.ca.
authors: Eddy
authors: E
authors: Fan
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000941:ethics / Q000639:trends; D006801:Humans; D012121:Respiration, Artificial / Q000941:ethics / Q000639:trends; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000941:ethics / Q000639:trends