Long-term extracorporeal support for acute lung failure was introduced in 1972. In the 1970s, much effort was concentrated on technical improvements. However, a multicenter study comparing continuous positive-pressure ventilation and continuous positive-pressure ventilation plus extracorporeal circulation failed to show improvement in survival rates. In the 1980s, new physiopathologic concepts were developed, such as extracorporeal CO2 removal coupled with lung rest. The main complication of the technique was bleeding due to systemic heparinization. However, the technology used in that period was the same as in the 1970s. Recently, technological improvement--such as percutaneous cannulation and surface-heparinized artificial lungs--has allowed clinical performances to improve substantially. "Lung rest" philosophy, coupled with safe technology, may provide a rational basis to test this technique in a randomized fashion for widespread use.
|Titolo:||Role of extracorporeal circulation in adult respiratory distress syndrome management|
|Parole Chiave:||Multicenter Studies as Topic; Extracorporeal Membrane Oxygenation; Combined Modality Therapy; Humans; Respiratory Distress Syndrome, Adult; Clinical Trials as Topic; Lung Compliance; Pulmonary Gas Exchange; Oxygen Consumption; Survival Rate; Adult; Treatment Outcome; Rest; Blood Gas Analysis; Middle Aged; Positive-Pressure Respiration; Heparin; Lung Volume Measurements|
|Settore Scientifico Disciplinare:||Settore MED/41 - Anestesiologia|
|Data di pubblicazione:||nov-1993|
|Appare nelle tipologie:||01 - Articolo su periodico|