Research in Extracorporeal Life Support: A Call to Action

Daniel Brodie, Jean-Louise Vincent, Laurent J. Brochard, Alain Combes, Niall D. Ferguson, Carol L Hodgson, John G Laffey, Alain Mercat, Antonio Pesenti, Michael Quintel, Arthur S Slutsky, V. Marco Ranieri, on behalf of the International ECMO Network (EMCONet)

Research output: Contribution to journalComment / DebateOtherpeer-review

15 Citations (Scopus)

Abstract

Extracorporeal life support (ECLS) refers to a group of techniques that provide extracorporeal gas exchange or circulatory support for patients with respiratory or cardiac failure. The use of ECLS in adults has grown exponentially in the last decade,1,2 fueled both by technological advances in cardiopulmonary bypass equipment, from which ECLS was principally derived, and by several specific events. The perceived need for advanced respiratory support in patients with influenza A(H1N1)-associated ARDS during the 2009 pandemic,3 along with the publication of the Conventional Ventilation or ECMO for Severe Adult Respiratory Failure (CESAR) trial that same year,4 generated considerable interest in ECLS for
adult respiratory failure.5 Although use of cardiac ECLS was already growing, its use increased dramatically in some countries
after the publication of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial.2,6 The current growth of ECLS is outpacing the evidence base supporting its use.7-9 For example, in the last decade, only one large randomized clinical trial assessing the efficacy of ECLS for respiratory failure has been published; none has been published for cardiac failure.
This lack of data leaves us without definitive answers to a number of important questions, including the most fundamental: When is
ECLS indicated? Also, is it superior to the best current standard of care?
Original languageEnglish
Pages (from-to)788-791
Number of pages4
JournalChest
Volume153
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • ECLS
  • evidence
  • extracorporeal life support
  • research networks

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