Extracorporeal Life Support

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While the benefits of extracorporeal life support (ECLS) in the neonatal and pediatric populations are well recognized, the benefits of ECLS in the adult population as an adjunct treatment for cardiac arrest are still debated. Despite numerous advances in treatment of cardiac arrest, mortality and morbidity remain high due to the rates of return of spontaneous circulation and survival with minimal neurologic impairment remaining low. Recent evidence has shown that technological advances in the equipment utilized for ECLS and an enhanced knowledge base have improved the outcomes for patients treated with ECLS. The purpose of this paper is to evaluate the use of extracorporeal life support in adult patients with cardiac arrest based on reduced…show more content…
John H. Gibbon, Jr. utilized the heart and lung machine, or cardiopulmonary bypass support, to facilitate the first successful open heart operation (source??). ECLS was an adaptation of this conventional cardiopulmonary bypass introduced in the 1970s during the treatment of severe acute respiratory distress syndrome (ARDS). In 1972, Dr. J. Donald Hill published the first report of successful ECLS support of an adult trauma patient experiencing respiratory failure (Hill, O’Brien, Murray, Dontigny, Bramson, Osborn, & Gerbode, 1972). Three years later in 1975, Dr. Robert H. Bartlett successfully applied ECLS in the treatment of a newborn with meconium aspiration. Dr. Bartlett’s article published in 1982 spurred interest in the use of ECLS due to the demonstration of clear survival benefits in infants suffered from severe respiratory failure (Bartlett, Andrews, Toomasian, Haiduc, & Gazzaniga,…show more content…
The results of this trial, as published by Zapol et al. in 1979, failed to demonstrate a survival benefit with the use of ECLS over conventional therapy as mortality rates were 90% and 92% respectively. A second randomized controlled trial (RCT) was published in 1994 by Morris et al. again demonstrating no significant benefit in the adult population. Since these studies, ECLS has undergone significant changes and technological advances. In 2009, there was a resurgence of ECLS during the H1N1 influenza pandemic. Due to the positive outcomes and evolution of ECLS technology, a new dimension was added to the intensive care management of the adult population with cardiac and/or respiratory failure refractory to conventional treatment

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