Extracorporeal organ support in patients with dysfunction of vital organs like the kidney, heart, and liver has proven helpful in bridging the patients to recovery or more definitive therapy. Mechanical ventilation in patients with respiratory failure, although indispensable, has been associated with worsening injury to the lungs, termed ventilator-induced lung injury. Application of lung-protective ventilation strategies are limited by inevitable hypercapnia and hypercapnic acidosis. Various alternative extracorporeal strategies, proposed more than 30 years ago, to combat hypercapnia are now more readily available. In particular, the venovenous approach to effective carbon dioxide removal, which involves minimal invasiveness comparable to renal replacement therapy, appears to be very promising. The clinical applications of these extracorporeal carbon dioxide removal therapies may extend beyond just lung protection in ventilated patients. This article summarizes the rationale, technology and clinical application of various extracorporeal lung assist techniques available for clinical use, and some of the future perspectives in the field.

Keywords:
Lung-protective ventilation, Lung support, Extracorporeal carbon dioxide removal, Extracorporeal membrane oxygenation
1.
Martin GS, Mannino DM, Eaton S, Moss M: The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003;348:1546–1554.
2.
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR: Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001;29:1303–1310.
3.
Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD: Incidence and outcomes of acute lung injury. N Engl J Med 2005;353:1685–1693.
4.
Villar J, Blanco J, Anon JM, Santos-Bouza A, Blanch L, Ambros A, Gandia F, Carriedo D, Mosteiro F, Basaldua S, Fernandez RL, Kacmarek RM: The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med 2011;37:1932–1941.
5.
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med 2000;342:1301–1308.
6.
Terragni PP, Del Sorbo L, Mascia L, Urbino R, Martin EL, Birocco A, Faggiano C, Quintel M, Gattinoni L, Ranieri VM: Tidal volume lower than 6 ml/kg enhances lung protection: role of extracorporeal carbon dioxide removal. Anesthesiology 2009;111:826–835.
7.
Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD: Barriers to providing lung-protective ventilation to patients with acute lung injury. Crit Care Med 2004;32:1289–1293.
8.
Cruz D, Bellomo R, Kellum JA, de Cal M, Ronco C: The future of extracorporeal support. Crit Care Med 2008;36:S243–S252.
9.
Ronco C, Bellomo R: Acute renal failure and multiple organ dysfunction in the ICU: from renal replacement therapy (RRT) to multiple organ support therapy (MOST). Int J Artif Organs 2002;25:733–747.
10.
Gramaticopolo S, Chronopoulos A, Piccinni P, Nalesso F, Brendolan A, Zanella M, Cruz DN, Ronco C: Extracorporeal CO2 removal – a way to achieve ultraprotective mechanical ventilation and lung support: the missing piece of multiple organ support therapy. Contrib Nephrol 2010;165:174–184.
11.
Lassen HC: A preliminary report on the 1952 epidemic of poliomyelitis in Copenhagen with special reference to the treatment of acute respiratory insufficiency. Lancet 1953;i:37–41.
12.
Del Sorbo L, Slutsky AS: Acute respiratory distress syndrome and multiple organ failure. Curr Opin Critic Care 2011;17:1–6.
13.
Stapleton RD: Causes and timing of death in patients with ARDS. Chest 2005;128:525–532.
14.
Kregenow DA, Rubenfeld GD, Hudson LD, Swenson ER: Hypercapnic acidosis and mortality in acute lung injury. Crit Care Med 2006;34:1–7.
15.
Mekontso Dessap A, Charron C, Devaquet J, Aboab J, Jardin F, Brochard L, Vieillard-Baron A: Impact of acute hypercapnia and augmented positive end-expiratory pressure on right ventricle function in severe acute respiratory distress syndrome. Intensive Care Med 2009;35:1850–1858.
16.
Terragni PP, Rosboch G, Tealdi A, Corno E, Menaldo E, Davini O, Gandini G, Herrmann P, Mascia L, Quintel M, Slutsky AS, Gattinoni L, Ranieri VM: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome. Am J Respir Crit Care Med 2006;175:160–166.
17.
Hager DN: Tidal volume reduction in patients with acute lung injury when plateau pressures are not high. Am J Respir Crit Care Med 2005;172:1241–1245.
18.
Gattinoni L, Pesenti A, Kolobow T, Damia G: A new look at therapy of the adult respiratory distress syndrome: motionless lungs. Int Anesthesiol Clin 1983;21:97–117.
19.
Pesenti A, Patroniti N, Fumagalli R: Carbon dioxide dialysis will save the lung. Crit Care Med 2010;38:S549–S554.
20.
Hill JD, O’Brien TG, Murray JJ, Dontigny L, Bramson ML, Osborn JJ, Gerbode F: Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Engl J Med 1972;286:629–634.
21.
Kolobow T, Gattinoni L, Tomlinson TA, Pierce JE: Control of breathing using an extracorporeal membrane lung. Anesthesiology 1977;46:138–141.
22.
Gattinoni L, Kolobow T, Tomlinson T, Iapichino G, Samaja M, White D, Pierce J: Low-frequency positive pressure ventilation with extracorporeal carbon dioxide removal (LFPPV-ECCO2R): an experimental study. Anesth Analg 1978;57:470–477.
23.
Gattinoni L, Agostoni A, Pesenti A, Pelizzola A, Rossi GP, Langer M, Vesconi S, Uziel L, Fox U, Longoni F, Kolobow T, Damia G: Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO2. Lancet 1980;ii:292–294.
24.
Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F, Iapichino G, Romagnoli G, Uziel L, Agostoni A, et al: Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. JAMA 1986;256:881–886.
25.
Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC 2nd, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagniewski A, Miller RG Jr: Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. JAMA 1979;242:2193–2196.
26.
Morris AH, Wallace CJ, Menlove RL, Clemmer TP, Orme JF Jr, Weaver LK, Dean NC, Thomas F, East TD, Pace NL, Suchyta MR, Beck E, Bombino M, Sittig DF, Bohm S, Hoffmann B, Becks H, Butler S, Pearl J, Rasmusson B: Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med 1994;149:295–305.
27.
Toomasian JM, Schreiner RJ, Meyer DE, Schmidt ME, Hagan SE, Griffith GW, Bartlett RH, Cook KE: A polymethylpentene fiber gas exchanger for long-term extracorporeal life support. ASAIO J 2005;51:390–397.
28.
Strueber M: Extracorporeal support as a bridge to lung transplantation. Curr Opin Crit Care 2010;16:69–73.
29.
Extracorporeal Life Support Organization: ECLS Registry Report. International Summary. Ann Arbor, Extracorporeal Life Support Organization, 2011.
30.
Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, Hibbert CL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D: Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009;374:1351–1363.
31.
Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N, Forrest P, Gattas D, Granger E, Herkes R, Jackson A, McGuinness S, Nair P, Pellegrino V, Pettila V, Plunkett B, Pye R, Torzillo P, Webb S, Wilson M, Ziegenfuss M: Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 2009;302:1888–1895.
32.
Freed DH, Henzler D, White CW, Fowler R, Zarychanski R, Hutchison J, Arora RC, Manji RA, Legare J-F, Drews T, Veroukis S, Kesselman M, Guerguerian A-M, Kumar A: Extracorporeal lung support for patients who had severe respiratory failure secondary to influenza A (H1N1) 2009 infection in Canada. Can J Anesth 2010;57:240–247.
33.
Roch A, Lepaul-Ercole R, Grisoli D, Bessereau J, Brissy O, Castanier M, Dizier S, Forel JM, Guervilly C, Gariboldi V, Collart F, Michelet P, Perrin G, Charrel R, Papazian L: Extracorporeal membrane oxygenation for severe influenza A (H1N1) acute respiratory distress syndrome: a prospective observational comparative study. Intensive Care Med 2010;36:1899–1905.
34.
Patroniti N, Zangrillo A, Pappalardo F, Peris A, Cianchi G, Braschi A, Iotti GA, Arcadipane A, Panarello G, Ranieri VM, Terragni P, Antonelli M, Gattinoni L, Oleari F, Pesenti A: The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks. Intensive Care Med 2011;37:1447–1457.
35.
Noah MA, Peek GJ, Finney SJ, Griffiths MJ, Harrison DA, Grieve R, Sadique MZ, Sekhon JS, McAuley DF, Firmin RK, Harvey C, Cordingley JJ, Price S, Vuylsteke A, Jenkins DP, Noble DW, Bloomfield R, Walsh TS, Perkins GD, Menon D, Taylor BL, Rowan KM: Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1). JAMA 2011;306:1659–1668.
36.
Hemmila MR, Rowe SA, Boules TN, Miskulin J, McGillicuddy JW, Schuerer DJ, Haft JW, Swaniker F, Arbabi S, Hirschl RB, Bartlett RH: Extracorporeal life support for severe acute respiratory distress syndrome in adults. Ann Surg 2004;240:595–605.
37.
Ma DS, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW: Outcomes of venovenous extracorporeal membrane oxygenation support for acute respiratory distress syndrome in adults. Korean J Thorac Cardiovasc Surg 2012;45:91–94.
38.
Javidfar J, Brodie D, Wang D, Ibrahimiye AN, Yang J, Zwischenberger JB, Sonett J, Bacchetta M: Use of bicaval dual-lumen catheter for adult venovenous extracorporeal membrane oxygenation. Ann Thorac Surg 2011;91:1763–1768; discussion 1769.
39.
Muller T, Lubnow M, Philipp A, Bein T, Jeron A, Luchner A, Rupprecht L, Reng M, Langgartner J, Wrede CE, Zimmermann M, Birnbaum D, Schmid C, Riegger GA, Pfeifer M: Extracorporeal pumpless interventional lung assist in clinical practice: determinants of efficacy. Eur Respir J 2009;33:551–558.
40.
Flörchinger B, Philipp A, Klose A, Hilker M, Kobuch R, Rupprecht L, Keyser A, Pühler T, Hirt S, Wiebe K, Müller T, Langgartner J, Lehle K, Schmid C: Pumpless extracorporeal lung assist: a 10-year institutional experience. Ann Thorac Surg 2008;86:410–417.
41.
Bein T, Weber F, Philipp A, Prasser C, Pfeifer M, Schmid F-X, Butz B, Birnbaum D, Taeger K, Schlitt HJ: A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 2006;34:1372–1377.
42.
Zimmermann M, Bein T, Arlt M, Philipp A, Rupprecht L, Mueller T, Lubnow M, Graf BM, Schlitt HJ: Pumpless extracorporeal interventional lung assist in patients with acute respiratory distress syndrome: a prospective pilot study. Crit Care 2009;13:R10.
43.
Conrad SA, Zwischenberger JB, Grier LR, Alpard SK, Bidani A: Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study. Intensive Care Med 2001;27:1340–1351.
44.
Ricci D, Boffini M, Del Sorbo L, El Qarra S, Comoglio C, Ribezzo M, Bonato R, Ranieri VM, Rinaldi M: The use of CO2 removal devices in patients awaiting lung transplantation: an initial experience. Transplant Proc 2010;42:1255–1258.
45.
Fischer S, Hoeper MM, Bein T, Simon AR, Gottlieb J, Wisser W, Frey L, Van Raemdonck D, Welte T, Haverich A, Strueber M: Interventional lung assist: a new concept of protective ventilation in bridge to lung transplantation. ASAIO J 2008;54:3–10.
46.
Wiebe K, Poeling J, Arlt M, Philipp A, Camboni D, Hofmann S, Schmid C: Thoracic surgical procedures supported by a pumpless interventional lung assist. Ann Thorac Surg 2010;89:1782–1788.
47.
Bein T, Scherer MN, Philipp A, Weber F, Woertgen C: Pumpless extracorporeal lung assist (pECLA) in patients with acute respiratory distress syndrome and severe brain injury. J Trauma 2005;58:1294–1297.
48.
Zimmermann M, Bein T, Philipp A, Ittner K, Foltan M, Drescher J, Weber F, Schmid FX: Interhospital transportation of patients with severe lung failure on pumpless extracorporeal lung assist. Br J Anaesth 2006;96:63–66.
49.
Stirling SL, Cordingley JJ, Hunter DN, Griffiths MJ, Wort SJ, Evans TW, Finney SJ: Extracorporeal carbon dioxide removal to ‘protect’ the lung. Thorax 2009;64:726–727.
50.
Elliot SC, Paramasivam K, Oram J, Bodenham AR, Howell SJ, Mallick A: Pumpless extracorporeal carbon dioxide removal for life-threatening asthma. Crit Care Med 2007;35:945–948.
51.
Jung C, Lauten A, Pfeifer R, Bahrmann P, Figulla HR, Ferrari M: Pumpless extracorporeal lung assist for the treatment of severe, refractory status asthmaticus. J Asthma 2011;48:111–113.
52.
Brunston RL Jr, Tao W, Bidani A, Traber DL, Zwischenberger JB: Organ blood flow during arteriovenous carbon dioxide removal. ASAIO J 1997;43:M821–M824.
53.
Pesenti A, Rossi GP, Pelosi P, Brazzi L, Gattinoni L: Percutaneous extracorporeal CO2 removal in a patient with bullous emphysema with recurrent bilateral pneumothoraces and respiratory failure. Anesthesiology 1990;72:571–573.
54.
Livigni S, Maio M, Ferretti E, Longobardo A, Potenza R, Rivalta L, Selvaggi P, Vergano M, Bertolini G: Efficacy and safety of a low-flow veno-venous carbon dioxide removal device: results of an experimental study in adult sheep. Crit Care 2006;10:R151.
55.
Iacovazzi M, Oreste N, Sardelli P, Barrettara B, Grasso S: Extracorporeal carbon dioxyde removal for additional pulmonary resection after pneumonectomy. Minerva Anestesiol 2012;78:381–384.
56.
Burki N, Mani R, Herth F, Schmidt W, Teschler H, Bonin F: A novel extracorporeal CO2 removal system: application of the Hemolung in patients with hypercapnic respiratory failure. Am J Respir Crit Care Med 2011;183:A1697.
57.
Fischer S, Hoeper MM, Tomaszek S, Simon A, Gottlieb J, Welte T, Haverich A, Strueber M: Bridge to lung transplantation with the extracorporeal membrane ventilator Novalung in the veno-venous mode: the initial Hannover experience. ASAIO J 2007;53:168–170.
58.
Cox CS Jr, Zwischenberger JB, Kurusz M: Development and current status of a new intracorporeal membrane oxygenator (IVOX). Perfusion 1991;6:291–296.
59.
Gentilello LM, Jurkovich GJ, Gubler KD, Anardi DM, Heiskell R: The intravascular oxygenator (IVOX): preliminary results of a new means of performing extrapulmonary gas exchange. J Trauma 1993;35:399–404.
60.
Zwischenberger JB, Tao W, Bidani A: Intravascular membrane oxygenator and carbon dioxide removal devices: a review of performance and improvements. ASAIO J 1999;45:41–46.
61.
Mihelc KM, Frankowski BJ, Lieber SC, Moore ND, Hattler BG, Federspiel WJ: Evaluation of a respiratory assist catheter that uses an impeller within a hollow fiber membrane bundle. ASAIO J 2009;55:569–574.
62.
Kaar JL, Oh HI, Russell AJ, Federspiel WJ: Towards improved artificial lungs through biocatalysis. Biomaterials 2007;28:3131–3139.
63.
Mancini P 2nd, Whittlesey GC, Song JY, Salley SO, Klein MD: CO2 removal for ventilatory support: a comparison of dialysis with and without carbonic anhydrase to a hollow fiber lung. ASAIO Trans 1990;36:M675–M678.
64.
Czermak P, Razcuhn B, Walz M, Catapano G: Feasibility of continuous CO2 removal with hydrophilic membranes at low blood flow rates. Int J Artif Organs 2005;28:264–269.
65.
Gille JP, Saunier C, Schrijen F, Hartemann D, Tousseul B: Metabolic CO2 removal by dialysis: THAM vs NaOH infusion. Int J Artif Organs 1989;12:720–727.
66.
Ruzicka J, Novak I, Rokyta R, Matejovic M, Hadravsky M, Nalos M, Sramek V: Effects of ultrafiltration, dialysis, and temperature on gas exchange during hemodiafiltration: a laboratory experiment. Artif Organs 2001;25:961–966.
67.
Cressoni M, Zanella A, Epp M, Corti I, Patroniti N, Kolobow T, Pesenti A: Decreasing pulmonary ventilation through bicarbonate ultrafiltration: an experimental study. Crit Care Med 2009;37:2612–2618.
68.
Russ M, Deja M, Ott S, Bedarf J, Keckel T, Hiebl B, Wagner JJ, Unger JK: Experimental high-volume hemofiltration with predilutional tris-hydroxymethylaminomethane for correction of low tidal volume ventilation-induced acidosis. Artif Organs 2011;35:E108–E118.
69.
Zanella A, Patroniti N, Isgrò S, Albertini M, Costanzi M, Pirrone F, Scaravilli V, Vergnano B, Pesenti A: Blood acidification enhances carbon dioxide removal of membrane lung: an experimental study. Intensive Care Med 2009;35:1484–1487.
70.
Ricci Z, Ronco C: Pulmonary/renal interaction. Current Opin Crit Care 2010;16:13–18.
71.
Payen D, de Pont A-CJM, Sakr Y, Spies C, Reinhart K, Vincent J-L: A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008;12:R74.
72.
Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL: Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int 2009;76:422–427.
73.
Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL: Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564–2575.
74.
Ruberto F, Pugliese F, D’Alio A, Perrella S, D’Auria B, Ianni S, Anile M, Venuta F, Coloni GF, Pietropaoli P: Extracorporeal removal CO2 using a venovenous, low-flow system (Decapsmart) in a lung transplanted patient: a case report. Transplant Proc 2009;41:1412–1414.
75.
Reng M, Philipp A, Kaiser M, Pfeifer M, Gruene S, Schoelmerich J: Pumpless extracorporeal lung assist and adult respiratory distress syndrome. Lancet 2000;356:219–220.
76.
Ricci Z, Ronco C, Picardo S: CRRT in series with extracorporeal membrane oxygenation in pediatric patients. Kidney Int 2010;77:469–470; author reply 471.
77.
Santiago MJ, Sanchez A, Lopez-Herce J, Perez R, del Castillo J, Urbano J, Carrillo A: The use of continuous renal replacement therapy in series with extracorporeal membrane oxygenation. Kidney Int 2009;76:1289–1292.
78.
Rubin S, Poncet A, Wynckel A, Baehrel B: How to perform a haemodialysis using the arterial and venous lines of an extracorporeal life support. Eur J Cardiothorac Surg 2010;37:967–968.
79.
Hoover NG, Heard M, Reid C, Wagoner S, Rogers K, Foland J, Paden ML, Fortenberry JD: Enhanced fluid management with continuous venovenous hemofiltration in pediatric respiratory failure patients receiving extracorporeal membrane oxygenation support. Intensive Care Med 2008;34:2241–2247.
80.
Oshima K, Kunimoto F, Hinohara H, Ohkawa M, Mita N, Tajima Y, Saito S: Extracorporeal membrane oxygenation for respiratory failure: comparison of venovenous versus venoarterial bypass. Surg Today 2010;40:216–222.
81.
Bein T, Weber F, Philipp A, Prasser C, Pfeifer M, Schmid FX, Butz B, Birnbaum D, Taeger K, Schlitt HJ: A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 2006;34:1372–1377.
82.
Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, Olsson KM, Greer M, Sommer W, Welte T, Haverich A, Hoeper MM, Warnecke G: Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. Am J Respir Crit Care Med 2012;185:763–768.
83.
Ricci D, Boffini M, Del Sorbo L, El Qarra S, Comoglio C, Ribezzo M, Bonato R, Ranieri VM, Rinaldi M: The use of CO2 removal devices in patients awaiting lung transplantation: an initial experience. Transplant Proc 2010;42:1255–1258.
84.
Fischer S, Simon AR, Welte T, Hoeper MM, Meyer A, Tessmann R, Gohrbandt B, Gottlieb J, Haverich A, Strueber M: Bridge to lung transplantation with the novel pumpless interventional lung assist device NovaLung. J Thorac Cardiovasc Surg 2006;131:719–723.
85.
Hammainen P, Schersten H, Lemstrom K, Riise GC, Kukkonen S, Sward K, Sipponen J, Silverborn M, Dellgren G: Usefulness of extracorporeal membrane oxygenation as a bridge to lung transplantation: a descriptive study. J Heart Lung Transplant 2011;30:103–107.
86.
Moscatelli A, Ottonello G, Nahum L, Lampugnani E, Puncuh F, Simonini A, Tumolo M, Tuo P: Noninvasive ventilation and low-flow veno-venous extracorporeal carbon dioxide removal as a bridge to lung transplantation in a child with refractory hypercapnic respiratory failure due to bronchiolitis obliterans. Pediatr Crit Care Med 2010;11:e8–e12.
87.
Tonan M, Hashimoto S, Kimura A, Matsuyama H, Kinose H, Sawada M, Shime N, Tokuhira N, Kato Y, Sasaki M, Tsuchiya K, Higaki S, Oomae T: Successful treatment of severe asthma-associated plastic bronchitis with extracorporeal membrane oxygenation. J Anesth 2012;26:265–268.
88.
Guarracino F, Stefani M, Maremmani P, Corini M, Pini S, Tascini C, Menichetti F, Ambrosino N: Influenza A triggered status asthmaticus requiring emergency ECMO. Monaldi Arch Chest Dis 2010;73:162–165.
89.
Mydin M, Berman M, Klein A, Tsui S, Dunning J, Valchanov K, Vuylsteke A, Jenkins DP: Extracorporeal membrane oxygenation as a bridge to pulmonary endarterectomy. Ann Thorac Surg 2011;92:e101–e103.
90.
Bauer C, Vichova Z, Ffrench P, Hercule C, Jegaden O, Bastien O, Lehot JJ: Extracorporeal membrane oxygenation with danaparoid sodium after massive pulmonary embolism. Anesth Analg 2008;106:1101–1103.
91.
Fica M, Suarez F, Aparicio R, Suarez C: Single site venovenous extracorporeal membrane oxygenation as an alternative to invasive ventilation in post-pneumonectomy fistula with acute respiratory failure. Eur J Cardiothorac Surg 2012;41:950–952.
92.
Hommel M, Deja M, von Dossow V, Diemel K, Heidenhain C, Spies C, Weber-Carstens S: Bronchial fistulae in ARDS patients: management with an extracorporeal lung assist device. Eur Respir J 2008;32:1652–1655.
93.
Bombino M, Patroniti N, Foti G, Isgro S, Grasselli G, Pesenti A: Bronchopleural fistulae and pulmonary ossification in posttraumatic acute respiratory distress syndrome: successful treatment with extracorporeal support. ASAIO J 2011;57:336–340.
94.
Wiebe K, Poeling J, Arlt M, Philipp A, Camboni D, Hofmann S, Schmid C: Thoracic surgical procedures supported by a pumpless interventional lung assist. Ann Thorac Surg 2010;89:1782–1787; discussion 1788.
95.
Peek GJ, Elbourne D, Mugford M, Tiruvoipati R, Wilson A, Allen E, Clemens F, Firmin R, Hardy P, Hibbert C, Jones N, Killer H, Thalanany M, Truesdale A: Randomised controlled trial and parallel economic evaluation of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR). Health Technol Assess 2010;14:1–46.
96.
Patroniti N, Zangrillo A, Pappalardo F, Peris A, Cianchi G, Braschi A, Iotti GA, Arcadipane A, Panarello G, Ranieri VM, Terragni P, Antonelli M, Gattinoni L, Oleari F, Pesenti A: The Italian ECMO network experience during the 2009 influenza A(H1N1) pandemic: preparation for severe respiratory emergency outbreaks. Intensive Care Med 2011;37:1447–1457.
97.
Johnson P, Frohlich S, Westbrook A: Use of extracorporeal membrane lung assist device (Novalung) in H1N1 patients. J Card Surg 2011;26:449–452.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.