title: Extracorporeal respiratory support in adult patients.
abstract: In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support. We discuss the history of respiratory support using ECMO in adults, as well as the clinical evidence; costs; indications; installation of the equipment; ventilator settings; daily care of the patient and the system; common troubleshooting; weaning; and discontinuation.
authors.affiliation: . Disciplina de Nefrologia, Faculdade de Medicina do ABC, Santo André (SP) Brasil.|. Hospital Sírio-Libanês, São Paulo (SP) Brasil.
authors.forename: Thiago Gomes
authors.initials: TG
authors.lastname: Romano
authors.affiliation: . Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.|. Hospital Sírio-Libanês, São Paulo (SP) Brasil.
authors.forename: Pedro Vitale
authors.initials: PV
authors.lastname: Mendes
authors.affiliation: . Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Park
authors.affiliation: . Hospital Sírio-Libanês, São Paulo (SP) Brasil.|. UTI Respiratória, Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil.
authors.forename: Eduardo Leite Vieira
authors.initials: EL
authors.lastname: Costa
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D006801:Humans; D006935:Hypercapnia; D000860:Hypoxia; D012128:Respiratory Distress Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000503:physiopathology / Q000628:therapy