Extracorporeal Life Support – Systems, Indications, and Limitations

Abstract

Extracorporeal life support is becoming increasingly popular with the miniaturization of the devices necessary for cardiac and pulmonary support. In the present report, the current systems, indications for placement and limitations are reviewed.

Key words

ECMO - extracorporeal life support - PECLA

References

• 1 Gibbon Jr J H. Application of a mechanical heart and lung apparatus to cardiac surgery.  Minn Med. 1954;  37 171-180
• 2 Thiagarajan R R, Brogan T V, Scheurer M A et al. Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation in adults.  Ann Thorac Surg. 2009;  87 778-785
• 3 Extracorporeal Life Support Organization .ELSO registry page. www.elso.med.umich.edu/registry.htm
• 4 Rashkind W J, Freeman A, Klein D, Toft R W. Evaluation of a disposable plastic, low volume, pumpless oxygenator as a lung substitute.  J Pediatr. 1965;  66 94-102
• 5 Dorson Jr W, Baker E, Cohen M L et al. A perfusion system for infants.  Trans Am Soc Artif Intern Organs. 1969;  15 155-160
• 6 Hill J D, O'Brien T G, Murray J J et al. Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung.  N Engl J Med. 1972;  286 629-634
• 7 Bartlett R H, Gazzaniga A B, Jefferies M R. Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy.  Trans Am Soc Artif Intern Organs. 1976;  22 80-93
• 8 Philipp A, Behr R, Reng M. Pumpless extracorporeal lung assist.  J Extracorp Technology. 1998;  30 38-41
• 9 Lewandowski K. Extracorporeal membrane oxygenation for severe acute respiratory failure.  Crit Care. 2000;  4 156-168
• 10 Kolobow T, Gattinoni L, Tomlinson T et al. The carbon dioxide membrane lung (CDML): a new concept.  Trans Am Soc Artif Intern Organs. 1977;  23 17-21
• 11 Marcolin R, Mascheroni D, Pesenti A et al. Ventilatory impact of partial extracorporeal CO₂ removal (PECOR) in ARF patients.  ASAIO Trans. 1986;  32 508-510
• 12 Terasaki H, Nogami T, Saito Y et al. Extracorporeal lung assist without endotracheal intubation and mechanical pulmonary ventilation.  Crit Care Med. 1987;  15 84-85
• 13 Zapol W M, Snider M T, Hill J D et al. Extracorporeal membrane oxygenation in severe acute respiratory failure: a randomized prospective study.  Am Med Assoc. 1979;  242 2193-2199
• 14 Fullerton D A, McIntyre Jr R C, Kirson L E et al. Impact of respiratory acid-base status in patients with pulmonary hypertension.  Ann Thorac Surg. 1996;  61 696-701
• 15 Müller T, Lubnow M, Bein T et al. Extrakorporale Lungenunterstützungsverfahren beim ARDS des Erwachsenen: eine Standortbestimmung.  Intensivmed. 2009;  46 109-119
• 16 Florchinger B, Philipp A, Klose A et al. Pumpless extracorporeal lung assist: a 10-year institutional experience.  Ann Thorac Surg. 2008;  86 410-417
• 17 Shuhaiber J H, Jenkins D, Berman M et al. The Papworth experience with the Levitronix CentriMag ventricular assist device.  J Heart Lung Transplant. 2008;  27 158-164
• 18 Camboni D, Philipp A, Hirt S, Schmid C. Possibilities and limitations of a miniaturized long-term extracorporeal life support system as bridge to transplantation in a case with biventricular heart failure.  Interact Cardiovasc Thorac Surg. 2008;  8 168-170
• 19 Doll N, Fabricius A, Borger M A et al. Temporary extracorporeal membrane oxygenation in patients with refractory postoperative cardiogenic shock–a single center experience.  J Card Surg. 2003;  18 512-518
• 20 Bayrakci B, Josephson C, Fackler J. Oxygenation index for extracorporeal membrane oxygenation: is there predictive significance?.  J Artif Organs. 2007;  10 6-9
• 21 Schuerer D J, Kolovos N S, Boyd K V, Coopersmith C M. Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.  Chest. 2008;  134 179-184
• 22 Alsoufi B, Al-Radi O O, Nazer R I et al. Survival outcomes after rescue extracorporeal cardiopulmonary resuscitation in pediatric patients with refractory cardiac arrest.  J Thorac Cardiovasc Surg. 2007;  134 952-959e2
• 23 Arlt M, Philipp A, Zimmermann M et al. First experiences with a new miniaturised life support system for mobile percutaneous cardiopulmonary bypass.  Resuscitation. 2008;  77 345-350
• 24 Lin C Y, Tsai F C, Tian Y C et al. Evaluation of outcome scoring systems for patients on extracorporeal membrane oxygenation.  Ann Thorac Surg. 2007;  84 1256-1262
• 25 Combes A, Leprince P, Luyt C E et al. Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock.  Crit Care Med. 2008;  36 1404-1411
• 26 Conrad S A, Rycus P T, Dalton H. Extracorporeal life support registry report 2004.  Asaio J. 2005;  51 4-10
• 27 Hemmila M R, Rowe S A, Boules T N et al. Extracorporeal life support for severe acute respiratory distress syndrome in adults.  Ann Surg. 2004;  240 595-605 discussion 605-607
• 28 Rastan A J, Lachmann N, Walther T et al. Autopsy findings in patients on postcardiotomy extracorporeal membrane oxygenation (ECMO).  Int J Artif Organs. 2006;  29 1121-1131
• 29 Formica F, Avalli L, Martino A et al. Extracorporeal membrane oxygenation with a poly-methylpentene oxygenator (Quadrox D). The experience of a single Italian centre in adult patients with refractory cardiogenic shock.  Asaio J. 2008;  54 89-94
• 30 Peek G J, Clemens F, Elbourne D et al. CESAR: conventional ventilatory support vs. extracorporeal membrane oxygenation for severe adult respiratory failure.  BMC Health Serv Res. 2006;  6 163
• 31 Zimpfer D, Heinisch B, Czerny M et al. Late vascular complications after extracorporeal membrane oxygenation support.  Ann Thorac Surg. 2006;  81 892-895
• 32 Madershahian N, Nagib R, Wippermann J et al. A simple technique of distal limb perfusion during prolonged femoro-femoral cannulation.  J Card Surg. 2006;  21 168-169
• 33 Huang S C, Yu H Y, Ko W J, Chen Y S. Pressure criterion for placement of distal perfusion catheter to prevent limb ischemia during adult extracorporeal life support.  J Thorac Cardiovasc Surg. 2004;  128 776-777
• 34 Yoshimura N, Ataka K, Nakagiri K et al. A simple technique for the prevention of lower limb ischemia during femoral veno-arterial cardiopulmonary support.  J Cardiovasc Surg (Torino). 1996;  37 557-559
• 35 Doll N, Kiaii B, Borger M et al. Five-year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock.  Ann Thorac Surg. 2004;  77 151-157
• 36 Ko W J, Lin C Y, Chen R J et al. Extracorporeal membrane oxygenation support for adult postcardiotomy cardiogenic shock.  Ann Thorac Surg. 2002;  73 538-545
• 37 Schmid C, Philipp A, Hilker M et al. Bridge to lung transplantation through a pulmonary artery to left atrial oxygenator circuit.  Ann Thorac Surg. 2008;  85 1202-1205