Troubleshooting in extracorporeal life support.

Since the first clinical use of extracorporeal circulation in the last century by John Gibbon and the first successful mechanical support of the left ventricular function by Forest Dodrill, the progress of techniques and technologies has helped to develop minimised systems for extracorporeal circulatory and respiratory support. However, the fact is that, despite the advanced technologies used for extracorporeal support, successful application in order to be benefit a critically ill population requires highly trained and skilled teams. Application of these highly sophisticated techniques in life-saving situations inside and/or outside the operating room is a procedure with certain pitfalls and dangers. The aim of this review is to provide a short overview of the technical aspects of extracorporeal circulation, with a look at the recent literature and clinical experiences focusing on technical as well surgical considerations regarding the urgent and/or emergent usage of a central as well as peripheral extracorporeal system.

[1]  L. V. von Segesser,et al.  Limitations using the vacuum-assist venous drainage technique during cardiopulmonary bypass procedures. , 2003, The journal of extra-corporeal technology.

[2]  L. V. von Segesser,et al.  Temporary caval stenting improves venous drainage during cardiopulmonary bypass. , 2008, Interactive cardiovascular and thoracic surgery.

[3]  D. Berdajs,et al.  Superior venous drainage in the “LifeBox”: a portable extracorporeal oxygenator with a self-expanding venous cannula , 2010, Perfusion.

[4]  H. Hirose,et al.  Right ventricular rupture and tamponade caused by malposition of the Avalon cannula for venovenous extracorporeal membrane oxygenation , 2012, Journal of Cardiothoracic Surgery.

[5]  P. Tarsia,et al.  Extracorporeal membrane oxygenation with spontaneous breathing as a bridge to lung transplantation. , 2013, Interactive cardiovascular and thoracic surgery.

[6]  A. Pavie,et al.  Venoarterial Extracorporeal Membrane Oxygenation Support for Refractory Cardiovascular Dysfunction During Severe Bacterial Septic Shock* , 2013, Critical care medicine.

[7]  D. Berdajs,et al.  Self-expanding mini-cannula for remote perfusion with pediatric scenarios. , 2010, Interactive cardiovascular and thoracic surgery.

[8]  R. Cheng,et al.  Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients. , 2014, The Annals of thoracic surgery.

[9]  Michael Bailey,et al.  Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. , 2009, JAMA.

[10]  Extracorporeal Membrane Oxygenation for 2009 Influenza A ( H 1 N 1 ) Acute Respiratory Distress Syndrome , 2009 .

[11]  F. Mohr,et al.  Extracorporeal membrane oxygenation: experience in acute graft failure after heart transplantation , 2014, Clinical transplantation.

[12]  N. Uriel,et al.  Clinical outcome of mechanical circulatory support for refractory cardiogenic shock in the current era. , 2013, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[13]  A. Gacouin,et al.  Avalon© Bicaval Dual-Lumen Cannula for Venovenous Extracorporeal Membrane Oxygenation: Survey of Cannula Use in France , 2013, ASAIO journal.

[14]  D. Berdajs Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation: Avalon© cannula in childhood disease , 2015, Perfusion.

[15]  S. Bolling,et al.  Extracorporeal life support to left ventricular assist device bridge to heart transplant: A strategy to optimize survival and resource utilization. , 1999, Circulation.

[16]  R. Bartlett,et al.  Contemporary extracorporeal membrane oxygenation for adult respiratory failure: life support in the new era , 2012, Intensive Care Medicine.

[17]  L. Segesser Peripheral cannulation for cardiopulmonary bypass , 2006 .

[18]  R. Bartlett,et al.  Current status of extracorporeal life support (ECMO) for cardiopulmonary failure. , 2010, Minerva anestesiologica.

[19]  D. Berdajs,et al.  New prototype of femoral arterial SmartCannula with anterograde and retrograde flow , 2011, Perfusion.

[20]  Diana Elbourne,et al.  Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial , 2009, The Lancet.

[21]  J. Haft,et al.  Optimal Endovascular Methods for Placement of Bicaval Dual-Lumen Cannulae for Venovenous Extracorporeal Membrane Oxygenation , 2013, ASAIO journal.

[22]  F. Beyersdorf,et al.  Short-term heart and lung support: extracorporeal membrane oxygenation and extracorporeal life support. , 2013, Multimedia manual of cardiothoracic surgery : MMCTS.

[23]  R. Bartlett,et al.  The use of extracorporeal life support in adult patients with primary cardiac failure as a bridge to implantable left ventricular assist device. , 2001, The Annals of thoracic surgery.

[24]  J. Beca,et al.  Extracorporeal membrane oxygenation for treating severe cardiac and respiratory failure in adults: part 2-technical considerations. , 2010, Journal of cardiothoracic and vascular anesthesia.

[25]  L. Cohn Fifty years of open-heart surgery. , 2003, Circulation.

[26]  B. Griffith,et al.  Ambulatory extracorporeal membrane oxygenation: a new approach for bridge-to-lung transplantation. , 2010, The Journal of thoracic and cardiovascular surgery.