Extracorporeal life support (ECLS) is a means to improving oxygenation, ventilation and hemodynamic support using an extracorporeal circuit comprised of an oxygenator and a centrifugal pump. Traditionally, its indications have spanned refractory hypoxemic or hypercapnic respiratory failure, and cardiogenic shock. Over the years, substantial advancements in the technology have resulted in increased safety and minimised the complexity associated with its use.
Recent evidence suggests the possibility of favourable outcomes associated with the use of ECLS for severe, acute respiratory failure; however, there are limited data from large, randomized controlled trials to confirm efficacy. Therefore, more evidence will be needed to guide clinicians on its role in patients with severe, acute respiratory failure.
This review will focus primarily on ECLS for hypoxemic and hypercapnic respiratory failure.
Note: Potential applications for ECLS:
- Cardiogenic shock
Significant technologic advancements have renewed enthusiasm for the role of ECLS in adults with respiratory failure.