J.Jpn. Surg. Soc.. 121(6): 586-593, 2020

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EXTRACORPOREAL MEMBRANE OXYGENATION FOR SEVERE RESPIRATORY FAILURE

The scientific and technological evolution of extracorporeal membrane oxygenation (ECMO) devices and advances in overall intensive care have provided a better understanding of and improved management techniques for veno–venous ECMO. ECMO therapy for severe respiratory failure is administered for pulmonary support from the viewpoint of avoiding ventilator-induced lung injury and patient self-inflicted lung injury. The ECM to Rescue Lung Injury in Severe ARDS (EOLIA) trials and subsequent analyses demonstrated the effectiveness of early introduction of ECMO for severe acute respiratory distress syndrome. It was also found that cardiac support combined with respiratory support in conditions such as severe septic shock is an effective hybrid treatment mode. However, ECMO is a complex, high-risk, expensive medical technique that requires a trained specialized team and should be integrated into facilities with sufficient experience and number of cases.

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