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01-09-2017 | Review

The ICM research agenda on extracorporeal life support

Authors: Alain Combes, Dan Brodie, Yih-Sharng Chen, Eddy Fan, José P. S. Henriques, Carol Hodgson, Philipp M. Lepper, Pascal Leprince, Kunihiko Maekawa, Thomas Muller, Sebastian Nuding, Dagmar M. Ouweneel, Antoine Roch, Matthieu Schmidt, Hiroo Takayama, Alain Vuylsteke, Karl Werdan, Laurent Papazian

Published in: Intensive Care Medicine | Issue 9/2017

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.

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Title: The ICM research agenda on extracorporeal life support
Authors: Alain Combes
Dan Brodie
Yih-Sharng Chen
Eddy Fan
José P. S. Henriques
Carol Hodgson
Philipp M. Lepper
Pascal Leprince
Kunihiko Maekawa
Thomas Muller
Sebastian Nuding
Dagmar M. Ouweneel
Antoine Roch
Matthieu Schmidt
Hiroo Takayama
Alain Vuylsteke
Karl Werdan
Laurent Papazian
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 9/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4803-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The ICM research agenda on extracorporeal life support

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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Other articles of this Issue 9/2017

Pulmonary embolism following severe traumatic brain injury: incidence, risk factors and impact outcome

Death determined by neurological criteria: the next steps

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Intensive care medicine research agenda on invasive fungal infection in critically ill patients

The intensive care medicine research agenda for airways, invasive and noninvasive mechanical ventilation

The intensive care delirium research agenda: a multinational, interprofessional perspective