When the momentum has gone
| Autor: | Darryl Abrams, Matthew Bacchetta, Daniel Brodie |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Extracorporeal Circulation
medicine.medical_specialty Critical Care Pulmonary disease 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Severity of Illness Index Extracorporeal Hypercapnia Pulmonary Disease Chronic Obstructive 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine Carbon dioxide blood Momentum (finance) medicine Humans Intensive care medicine Respiratory Distress Syndrome Pulmonary Gas Exchange business.industry Carbon Dioxide Transplant Recipients Observational Studies as Topic 030228 respiratory system Observational study business Lung Transplantation |
| Zdroj: | Current Opinion in Critical Care. 24:23-28 |
| ISSN: | 1070-5295 |
| DOI: | 10.1097/mcc.0000000000000475 |
| Popis: | There has been expanding interest in and use of extracorporeal support in respiratory failure concurrent with technological advances and predominantly observational data demonstrating improved outcomes. However, until there is more available data from rigorous, high-quality randomized studies, the future of extracorporeal support remains uncertain.Outcomes for patients supported with extracorporeal devices continue to show favorable trends. There are several large randomized controlled trials that are in various stages of planning or completion for extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R) in the acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD), which may help clarify the role of this technology for these disease processes, and which stand to have a significant impact on a large proportion of patients with acute respiratory failure. Novel applications of extracorporeal lung support include optimization of donor organ quality through ex-vivo perfusion and extracorporeal cross-circulation, allowing for multimodal therapeutic interventions.Despite the ongoing rise in ECMO use for acute respiratory failure, its true value will not be known until more information is gleaned from prospective randomized controlled trials. Additionally, there are modalities beyond the current considerations for extracorporeal support that have the potential to revolutionize respiratory failure, particularly in the realm of chronic lung disease and lung transplantation. |
| Databáze: | OpenAIRE |
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