Description
This book presents a concise, evidence-based review of extracorporeal life support (ECLS) for adult diseases. It describes the use of ECLS with patients who are experiencing severe hypoxemic respiratory failure (ARDS and pneumonia), ventilatory failure (status asthmaticus and COPD), cardiogenic shock and circulatory or gas exchange failure following complications in cardiothoracic surgery, as well as its use as a bridge to lung transplant. Historically, clinicians have used ECLS as a last resort; however, this text details the technological improvements, evidence of improved outcomes and adverse consequences of alternative treatments that are causing this modality to be more commonly adopted. Topics include a description of the complex physiology and technology underlying ECLS; the evidence base for its use in specific clinical conditions; vascular access techniques; daily management of the circuit and patient; guidance regarding the weaning and decannulation process and recommendations for crisis management and rehabilitation related to ECLS. Extracorporeal Life Support for Adults is ideal reading for practicing physicians, nurses, perfusion specialists, therapists and critical care trainees who are considering whether to refer their patients for ECLS or are already providing ECLS and are seeking a practical reference to best practices and updated information. Dr. Schmidt’s investigative interests are in the areas of ICU ultrasound, sepsis therapy, ARDS, and judging the adequacy of volume replacement in patients in shock. With his former colleagues Jesse Hall and Lawrence D. H. Wood, he edits Principles of Critical Care (McGraw-Hill), now in its 4th edition. Clinical interests include extracorporeal membrane oxygenation (ECMO), septic shock, bedside ultrasound to guide fluid management, and analysis of ventilator waveforms of pressure and flow. Chapter 1. Physiology of Extracorporeal Life Support (ECLS) Matthew J. Brain, Warwick W. Butt, Graeme MacLaren Chapter 2. Hypoxemic Respiratory Failure: Evidence, Indications, Exclusions Darryl Abrams, Matthew Bacchetta, Daniel Brodie Chapter 3. Cardiogenic Shock: Evidence, Indications, Exclusions Nicolas Brchot, Alain Combes Chapter 4. ECCO2R in Obstructive Diseases: Evidence, Indications, Exclusions Lorenzo Del Sorbo, V. Marco Ranieri Chapter 5. ECLS as a Bridge to Lung Transplantation Christian Kuehn Chapter 6. Modes of ECLS L. Keith Scott, Benjamin Schmidt Chapter 7. Vascular Access for ECLS Steven A. Conrad Chapter 8. Circuits, Membranes, and Pumps Bradley H. Rosen Chapter 9. Ventilator Management during ECLS Antonio Pesenti, Giacomo Bellani, Giacomo Grasselli, Tommaso Mauri Chapter 10. Daily Care on ECLS Giles J. Peek Chapter 11. Crises during ECLS Cara L. Agerstrand, Linda B. Mongero, Darryl Abrams, Matthew Bacchetta, Daniel Brodie Chapter 12. Mobilization during ECLS Gregory A. Schmidt Chapter 13. ECMO Weaning and Decannulation Sundar Krishnan and Gregory A. Schmidt Chapter 14. The Story of ECLS: History and Future J. Ann Morris, Robert Pollock, Brittany A. Zwischenberger, Cherry Ballard-Croft, Joseph B. Zwischenberger
