The ICM research agenda on extracorporeal life support

The ICM research agenda on extracorporeal life support Purpose: This study aimed to concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be per‑ formed over the next decade and their expected outcomes with regard to extracorporeal membrane oxygenation (ECMO). Methods: Narrative review based on a systematic analysis of the medical literature, national and international guide‑ lines, and expert opinion. Results: The use of venovenous ECMO ( VV‑ ECMO) is increasing in the most severe forms of acute lung injury. In patients with cardiogenic shock, short‑ term veno‑ arterial ECMO ( VA‑ ECMO) provides both pulmonary and circulatory support. Technological improvements and recently published studies suggest that ECMO is able to improve patients’ outcomes. There are, however, many uncertainties regarding the real benefits of this technique both in hemody‑ namic and respiratory failure, the territorial organization to deliver ECMO, the indications and the use of concomitant treatments. Conclusions: Although there have been considerable advances regarding the use of ECMO in critically ill patients, the risk/benefit ratio remains underinvestigated. ECMO indications, organization of ECMO delivery, and use of adju‑ vant therapeutics need also to be explored. Ongoing and future http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Intensive Care Medicine Springer Journals
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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2017 by Springer-Verlag Berlin Heidelberg and ESICM
Subject
Medicine & Public Health; Intensive / Critical Care Medicine; Anesthesiology; Emergency Medicine; Pneumology/Respiratory System; Pain Medicine; Pediatrics
ISSN
0342-4642
eISSN
1432-1238
D.O.I.
10.1007/s00134-017-4803-3
Publisher site
See Article on Publisher Site

Abstract

Purpose: This study aimed to concisely describe the current standards of care, major recent advances, common beliefs that have been contradicted by recent trials, areas of uncertainty, and clinical studies that need to be per‑ formed over the next decade and their expected outcomes with regard to extracorporeal membrane oxygenation (ECMO). Methods: Narrative review based on a systematic analysis of the medical literature, national and international guide‑ lines, and expert opinion. Results: The use of venovenous ECMO ( VV‑ ECMO) is increasing in the most severe forms of acute lung injury. In patients with cardiogenic shock, short‑ term veno‑ arterial ECMO ( VA‑ ECMO) provides both pulmonary and circulatory support. Technological improvements and recently published studies suggest that ECMO is able to improve patients’ outcomes. There are, however, many uncertainties regarding the real benefits of this technique both in hemody‑ namic and respiratory failure, the territorial organization to deliver ECMO, the indications and the use of concomitant treatments. Conclusions: Although there have been considerable advances regarding the use of ECMO in critically ill patients, the risk/benefit ratio remains underinvestigated. ECMO indications, organization of ECMO delivery, and use of adju‑ vant therapeutics need also to be explored. Ongoing and future

Journal

Intensive Care MedicineSpringer Journals

Published: May 3, 2017

References

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