The ICM research agenda on extracorporeal life support

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 performed 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 guidelines, 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 hemodynamic 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 adjuvant therapeutics need also to be explored. Ongoing and future studies may be able to resolve these issues.
Document type :
Journal articles
Complete list of metadatas

Cited literature [82 references]  Display  Hide  Download

https://hal.sorbonne-universite.fr/hal-01677426
Contributor : Gestionnaire Hal-Upmc <>
Submitted on : Monday, January 8, 2018 - 12:28:56 PM
Last modification on : Tuesday, May 14, 2019 - 10:06:35 AM
Long-term archiving on: Friday, May 4, 2018 - 7:45:18 AM

File

The ICM research agenda on ext...
Files produced by the author(s)

Identifiers

Citation

Alain Combes, Dan Brodie, Yih-Sharng Chen, Eddy Fan, José P. S. Henriques, et al.. The ICM research agenda on extracorporeal life support. Intensive Care Medicine, Springer Verlag, 2017, 43 (9), pp.1306-1318. ⟨10.1007/s00134-017-4803-3⟩. ⟨hal-01677426⟩

Share

Metrics

Record views

295

Files downloads

576