Intensive Care Medicine

, Volume 38, Issue 2, pp 210–220 | Cite as

Contemporary extracorporeal membrane oxygenation for adult respiratory failure: life support in the new era

  • Graeme MacLarenEmail author
  • Alain Combes
  • Robert H. Bartlett



Extracorporeal membrane oxygenation (ECMO) has been used in clinical medicine for 40 years but remains controversial therapy, particularly in adult patients with severe respiratory failure. Over the last few years, there have been considerable advances in extracorporeal technology and clinical practice, ushering in a new era of ECMO. Many institutions adopted ECMO as rescue therapy during the recent H1N1 influenza pandemic, reigniting the controversy.


Hollow-fibre oxygenators and Mendler-designed centrifugal pumps have replaced the old silicon oxygenators and roller pumps. The advantages of these novel systems and the principles that underlie their function are outlined. Advances in cannula technology allow greater ease of patient positioning, in some cases facilitating extubation and ambulation on ECMO. Improvements in ECMO circuitry have led to a reduction in heparin and blood product requirements, with consequently fewer complications. Greater understanding of severe acute respiratory distress syndrome has allowed clinicians to successfully support adults on ECMO for months at a time, as a bridge to either recovery or transplantation.


ECMO is safer, cheaper, and simpler than in previous eras. Both circuit and patient can be cared for by a single trained nurse. Additional prospective studies of ECMO for adult respiratory failure are underway. Contemporary ECMO in awake, potentially ambulant patients to provide short-term support for those with acute, reversible respiratory failure and as a bridge to transplantation in those with irreversible respiratory failure is now ready for widespread evaluation.


Acute respiratory distress syndrome Mechanical ventilation Lung transplantation H1N1 influenza 


  1. 1.
    UK Collaborative ECMO Trial Group (1996) UK collaborative randomized trial of neonatal extracorporeal membrane oxygenation. Lancet 348:75–82CrossRefGoogle Scholar
  2. 2.
    Green TP, Timmons OD, Fackler JC, Moler FW, Thompson AE, Sweeney MF (1996) The impact of extracorporeal membrane oxygenation on survival in pediatric patients with acute respiratory failure. Pediatric Critical Care Study Group. Crit Care Med 24:323–329PubMedCrossRefGoogle Scholar
  3. 3.
    Cooper DS, Jacobs JP, Moore L, Stock A, Gaynor JW, Chancy T, Parpard M, Griffin DA, Owens T, Checchia PA, Thiagarajan RR, Spray TL, Ravishankar C (2007) Cardiac extracorporeal life support: start of the art in 2007. Cardiol Young 17:104–115PubMedCrossRefGoogle Scholar
  4. 4.
    Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, Hibbert CL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D, CESAR trial collaboration (2009) Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomized controlled trial. Lancet 374:1351–1363PubMedCrossRefGoogle Scholar
  5. 5.
    Zwischenberger JB, Lynch JE (2009) Will CESAR answer the adult ECMO debate? Lancet 374:1307–1308PubMedCrossRefGoogle Scholar
  6. 6.
    Park PK, Dalton HJ, Bartlett RH (2010) Point: efficacy of extracorporeal membrane oxygenation in 2009 influenza A(H1N1): sufficient evidence? Chest 138:776–778PubMedCrossRefGoogle Scholar
  7. 7.
    Morris AH, Hirshberg E, Miller RR 3rd, Statler KD, Hite RD (2010) Counterpoint: efficacy of extracorporeal membrane oxygenation in 2009 influenza A(H1N1): sufficient evidence? Chest 138:778–781PubMedCrossRefGoogle Scholar
  8. 8.
    Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce EC 2nd, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagniewski A, Miller RG Jr (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. JAMA 242:2193–2196PubMedCrossRefGoogle Scholar
  9. 9.
    Extracorporeal Life Support Organization (2011) ECLS registry report. International Summary, Ann ArborGoogle Scholar
  10. 10.
    MacLaren G, Butt W, Best D, Donath S, Taylor A (2007) Extracorporeal membrane oxygenation for refractory septic shock in children: one institution’s experience. Pediatr Crit Care Med 8:447–451PubMedCrossRefGoogle Scholar
  11. 11.
    MacLaren G, Butt W, Best D, Donath S (2011) Central extracorporeal membrane oxygenation for refractory pediatric septic shock. Pediatr Crit Care Med 12:133–136PubMedCrossRefGoogle Scholar
  12. 12.
    Michaels AJ, Schriener RJ, Kolla S, Awad SS, Rich PB, Reickert C, Younger J, Hirschl RB, Bartlett RH (1999) Extracorporeal life support in pulmonary failure after trauma. J Trauma 46:638–645PubMedCrossRefGoogle Scholar
  13. 13.
    Fortenberry JD, Meier AH, Pettignano R, Heard M, Chambliss CR, Wulkan M (2003) Extracorporeal life support for posttraumatic acute respiratory distrees syndrome at a children’s medical center. J Pediatr Surg 38:1221–1226PubMedCrossRefGoogle Scholar
  14. 14.
    Gow KW, Lao OB, Leong T, Fortenberry JD (2010) Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: the extracorporeal life support experience. Am J Surg 199:669–675PubMedCrossRefGoogle Scholar
  15. 15.
    Gow KW, Heiss KF, Wulkan ML, Katzenstein HM, Rosenberg ES, Heard ML, Rycus PT, Fortenberry JD (2009) Extracorporeal life support for support of children with malignancy and respiratory or cardiac failure: the extracorporeal life support experience. Crit Care Med 37:1308–1316PubMedCrossRefGoogle Scholar
  16. 16.
    Kolovos NS, Schuerer DJ, Moler FW, Bratton SL, Swaniker F, Bartlett RH, Custer JR, Annich G (2002) Extracorporeal life support for pulmonary hemorrhage in children: a case series. Crit Care Med 30:577–580PubMedCrossRefGoogle Scholar
  17. 17.
    Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators, Davies A, Jones D, Bailey M, Beca J, Bellomo R, Blackwell N, Forrest P, Gattas D, Granger E, Herkes R, Jackson A, McGuinness S, Nair P, Pellegrino V, Pettila V, Plunkett B, Pye R, Torzillo P, Webb S, Wilson M, Ziegenfuss M (2009) Extracorporeal membrane oxygenation for 2009 influenza A(H1N1) acute respiratory distress syndrome. JAMA 302:1888–1895PubMedCrossRefGoogle Scholar
  18. 18.
    Chan KK, Lee KL, Lam PK, Law KI, Joynt GM, Yan WW (2010) Hong Kong’s experience on the use of extracorporeal membrane oxygenation for the treatment of influenza A(H1N1). Hong Kong Med J 16:447–454PubMedGoogle Scholar
  19. 19.
    Turner DA, Williford WL, Peters MA, Thalman JJ, Shearer IR, Walczak RJ Jr, Griffs M, Olson SA, Sowers KW, Govert JA, Macintyre NR, Cheifetz IM (Epub 2011) Development of a collaborative program to provide extracorporeal membrane oxygenation for adults with refractory hypoxemia within the framework of a pandemic. Pediatr Crit Care Med 12:426–430Google Scholar
  20. 20.
    Bartlett RH, Gattinoni L (2010) Current status of extracorporeal life support (ECMO) for cardiopulmonary failure. Minerva Anestesiol 76:534–540PubMedGoogle Scholar
  21. 21.
    Cove ME, MacLaren G (2010) Clinical review: mechanical circulatory support for cardiogenic shock complicating acute myocardial infarction. Crit Care 14:235PubMedCrossRefGoogle Scholar
  22. 22.
    Chen YS, Chao A, Yu HY, Ko WJ, Wu IH, Chen RJ, Huang SC, Lin FY, Wang SS (2003) Analysis and results of prolonged resuscitation in cardiac arrest patients rescued by extracorporeal membrane oxygenation. J Am Coll Cardiol 41:197–203PubMedCrossRefGoogle Scholar
  23. 23.
    Magovern GJ Jr, Simpson KA (1999) Extracorporeal membrane oxygenation for adult cardiac support: the Allegheny experience. Ann Thorac Surg 68:655–661PubMedCrossRefGoogle Scholar
  24. 24.
    Pagani FD, Lynch W, Swaniker F, Dyke DB, Bartlett R, Koelling T, Moscucci M, Deeb GM, Bolling S, Monaghan H, Aaronson KD (1999) Extracorporeal life support to left ventricular assist device bridge to heart transplant: a strategy to optimize survival and resource utilization. Circulation 100:II206–II210PubMedGoogle Scholar
  25. 25.
    Smedira NG, Moazami N, Golding CM, McCarthy PM, Apperson-Hansen C, Blackstone EH, Cosgrove DM 3rd (2001) Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: survival at 5 years. J Thorac Cardiovasc Surg 122:92–102PubMedCrossRefGoogle Scholar
  26. 26.
    Combes A, Leprince P, Luyt CE, Bonnet N, Trouillet JL, Leger P, Pavie A, Chastre J (2008) Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med 36:1404–1411PubMedCrossRefGoogle Scholar
  27. 27.
    Chen JS, Ko WJ, Yu HY, Lai LP, Huang SC, Chi NH, Tsai CH, Wang SS, Lin FY, Chen YS (2006) Analysis of the outcome for patients experiencing myocardial infarction and cardiopulmonary resuscitation refractory to conventional therapies necessitating extracorporeal life support rescue. Crit Care Med 34:950–957PubMedCrossRefGoogle Scholar
  28. 28.
    Schwarz B, Mair P, Margreiter J, Pomaroli A, Hoermann C, Bonatti J, Lindner KH (2003) Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support. Crit Care Med 31:758–764PubMedCrossRefGoogle Scholar
  29. 29.
    Asaumi Y, Yasuda S, Morii I, Kakuchi H, Otsuka Y, Kawamura A, Sasako Y, Nakatani T, Nonogi H, Miyazaki S (2005) Favourable clinical outcome in patients with cardiogenic shock due to fulminant myocarditis supported by percutaneous extracorporeal membrane oxygenation. Eur Heart J 26:2185–2192PubMedCrossRefGoogle Scholar
  30. 30.
    Massetti M, Tasle M, Le Page O, Deredec R, Babatasi G, Buklas D, Thuaudet S, Charbonneau P, Hamon M, Grollier G, Gerard JL, Khayat A (2005) Back from irreversibility: extracorporeal life support for prolonged cardiac arrest. Ann Thorac Surg 79:178–183PubMedCrossRefGoogle Scholar
  31. 31.
    Doll N, Kiaii B, Borger M, Bucerius J, Kramer K, Schmitt DV, Walther T, Mohr FW (2004) Five-year results of 219 consecutive patients treated with extracorporeal membrane oxygenation for refractory postoperative cardiogenic shock. Ann Thorac Surg 77:151–157PubMedCrossRefGoogle Scholar
  32. 32.
    Peek GJ, Killer HM, Reeves R, Sosnowski AW, Firmin RK (2002) Early experience with a polymethyl pentene oxygenator for adult extracorporeal life support. ASAIO J 48:480–482PubMedCrossRefGoogle Scholar
  33. 33.
    Khoshbin E, Roberts N, Harvey C, Machin D, Killer H, Peek GJ, Sosnowski AW, Firmin RK (2005) Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation. ASAIO J 51:281–287PubMedCrossRefGoogle Scholar
  34. 34.
    Nishinaka T, Tatsumi E, Katagiri N, Ohnnishi H, Mizuno T, Shioya K, Tsukiya T, Homma A, Kashiwabara S, Tanaka H, Sato M, Taenaka Y (2007) Up to 151 days of continuous animal perfusion with trivial heparin infusion by the application of a long-term durable antithrombogenic coating to a combination of a seal-less centrifugal pump and a diffusion membrane oxygenator. J Artif Organs 10:240–244PubMedCrossRefGoogle Scholar
  35. 35.
    Mendler N, Podechtl F, Feil G, Hiltmann P, Sebening F (1995) Seal-less centrifugal blood pump with magnetically suspended rotor: rot-a-flot. Artif Organs 19:620–624PubMedCrossRefGoogle Scholar
  36. 36.
    Talor J, Yee S, Rider A, Kunselman AR, Guan Y, Undar A (2010) Comparison of perfusion quality in hollow-fiber membrane oxygenators for neonatal extracorporeal life support. Artif Organs 34:E110–E116PubMedCrossRefGoogle Scholar
  37. 37.
    Rho YR, Choi H, Lee JC, Choi SW, Chung YM, Lee HS, Hwang CM, Lee HS, Ahn SS, Lee RY, Son HS, Choi MJ, Baek KJ, Kim JS, Suh GJ, Won YS, Sun K, Min BG (2003) Applications of the pulsatile flow versatile ECLS: in vivo studies. Int J Artif Organs 26:428–435PubMedGoogle Scholar
  38. 38.
    Wang D, Zhou X, Liu X, Sidor B, Lynch J, Zwischenberger JB (2008) Wang-Zwische double lumen cannula–toward a percutaneous and ambulatory paracorporeal artificial lung. ASAIO J 54:606–611PubMedCrossRefGoogle Scholar
  39. 39.
    Bermudez CA, Rocha RV, Sappington PL, Toyoda Y, Murray HN, Boujoukos AJ (2010) Initial experience with single cannulation for venovenous extracorporeal oxygenation in adults. Ann Thorac Surg 90:991–995PubMedCrossRefGoogle Scholar
  40. 40.
    Preston TJ, Hodge AB, Riley JB, Leib-Sargel C, Nicol KK (2007) In vitro drug adsorption and plasma free hemoglobin levels associated with hollow fiber oxygenators in the extracorporeal life support (ECLS) circuit. J Extra Corpor Technol 39:234–237PubMedGoogle Scholar
  41. 41.
    Mehta NM, Halwick DR, Dodson BL, Thompson JE, Arnold JH (2007) Potential drug sequestration during extracorporeal membrane oxygenation: results from an ex vivo experiment. Intensive Care Med 33:1018–1124PubMedCrossRefGoogle Scholar
  42. 42.
    Wildschut ED, Ahsman MJ, Allegaert K, Mathot RA, Tibboel D (2010) Determinants of drug absorption in different ECMO circuits. Intensive Care Med 36:2109–2116PubMedCrossRefGoogle Scholar
  43. 43.
    Preston TJ, Ratliff TM, Gomez D, Olshove VE Jr, Nicol KK, Sargel CL, Chicoine LG (2010) Modified surface coatings and their effect on drug adsorption within the extracorporeal life support circuit. J Extra Corpor Technol 42:199–202PubMedGoogle Scholar
  44. 44.
    Gattinoni L, Agostini A, Pesenti A, Pelizzola A, Rossi GP, Langer M, Vesconi S, Uziel L, Fox U, Longoni F, Kolobow T, Damia G (1980) Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO2. Lancet 2:292–294PubMedCrossRefGoogle Scholar
  45. 45.
    Morris AH, Wallace CJ, Menlove RL, Clemmer TP, Orme JF Jr, Weaver LK, Dean NC, Thomas F, East TD, Pace NL, Suchyta MR, Beck E, Bombino M, Sittig DF, Bohm S, Hoffmann B, Becks H, Butler S, Pearl J, Rasmusson B (1994) Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome. Am J Respir Crit Care Med 149:295–305PubMedGoogle Scholar
  46. 46.
    Floerchinger B, Philipp A, Foltan M, Rupprecht L, Klose A, Camboni D, Bruenger F, Schopka S, Hilker M, Schmid C (2010) Switch from venoarterial extracorporeal membrane oxygenation to arteriovenous pumpless extracorporeal lung assist. Ann Thorac Surg 89:125–131PubMedCrossRefGoogle Scholar
  47. 47.
    Liebold A, Reng CM, Philipp A, Pfeifer M, Birndaum DE (2000) Pumpless extracorporeal lung assist—experience with the first 20 cases. Eur J Cardiothorac Surg 17:608–613PubMedCrossRefGoogle Scholar
  48. 48.
    Bein T, Weber F, Philipp A, Prasser C, Pfeifer M, Schmid FX, Butz B, Birnbaum D, Taeger K, Schlitt HJ (2006) A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia. Crit Care Med 34:1372–1377PubMedCrossRefGoogle Scholar
  49. 49.
    Bartlett RH, Chapman R (2005) Economics of ECLS. In: Van Meurs KP, Lally KP, Peek GJ, Zwischenberger JB (eds) ECMO, Extracorporeal cardiopulmonary support in critical care, 3rd edn. Extracorporeal Life Support Organization, Ann Arbor, pp 203–215Google Scholar
  50. 50.
    Extracorporeal Life Support Organization (2009) ELSO guidelines. Accessed 5 July 2011
  51. 51.
    Combes A (2011) Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (SARS). Accessed 29 March 2011
  52. 52.
    Extracorporeal Life Support Organization (2009) ELSO patient specific guidelines. Accessed 5 July 2011
  53. 53.
    Linden V, Palmer K, Reinhard J, Westman R, Ehren H, Granholm T, Frenckner B (2001) Inter-hospital transportation of patients with severe acute respiratory failure on extracorporeal membrane oxygenation—national and international experience. Intensive Care Med 27:1643–1648PubMedCrossRefGoogle Scholar
  54. 54.
    Nehra D, Goldstein AM, Doody DP, Ryan DP, Chang Y, Masiakos PT (2009) Extracorporeal membrane oxygenation for nonneonatal acute respiratory failure: the Massachusetts general hospital experience from 1990 to 2008. Arch Surg 144:427–432PubMedCrossRefGoogle Scholar
  55. 55.
    Linden V, Palmer K, Reinhard J, Westman R, Ehren H, Granholm T, Frenckner B (2000) High survival in adults patients with acute respiratory distress syndrome treated by extracorporeal membrane oxygenation, minimal sedation, and pressure supported ventilation. Intensive Care Med 26:1630–1637PubMedCrossRefGoogle Scholar
  56. 56.
    Trouillet JL, Luyt CE, Guiquet M, Ouattara A, Vaissier E, Makri R, Nieszkowska A, Leprince P, Pavie A, Chastre J, Combes A (2011) Early percutaneous tracheotomy versus prolonged intubation of mechanically ventilated patients after cardiac surgery: a randomized trial. Ann Intern Med 154:373–383PubMedGoogle Scholar
  57. 57.
    Olsson KM, Simon A, Strueber M, Hadem J, Wiesner O, Gottlieb J, Fuehner T, Fischer S, Warnecke G, Kuhn C, Haverich A, Welte T, Hoeper MM (2010) Extracorporeal membrane oxygenation in nonintubated patients as a bridge to lung transplantation. Am J Transpl 10:2173–2178CrossRefGoogle Scholar
  58. 58.
    Garcia JP, Iacono A, Kon ZN, Griffith BP (2010) Ambulatory extracorporeal membrane oxygenation: a new approach for bridge-to-lung transplantation. J Thorac Cardiovasc Surg 139:e137–e139PubMedCrossRefGoogle Scholar
  59. 59.
    Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, Spears L, Miller M, Franczyk M, Deprizio D, Schmidt GA, Bowman A, Barr R, McCallister KE, Hall JB, Kress JP (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomized controlled trial. Lancet 373:1874–1882PubMedCrossRefGoogle Scholar
  60. 60.
    Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, Jaber S, Arnal JM, Perez D, Seghboyan JM, Constantin JM, Courant P, Lefrant JY, Guerin C, Prat G, Morange S, Roch A (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363:1107–1116PubMedCrossRefGoogle Scholar
  61. 61.
    National Heart Blood Lung Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, Harabin AL (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575PubMedCrossRefGoogle Scholar
  62. 62.
    Rosenberg AL, Dechert RE, Park PK, Bartlett RH (2009) Review of a large clinical series: association of cumulative fluid balance on outcome in acute lung injury: a retrospective review of the ARDSnet tidal volume study cohort. J Intensive Care Med 24:35–46PubMedCrossRefGoogle Scholar
  63. 63.
    Green TP, Moler FW, Goodman DM (1995) Probability of survival after prolonged extracorporeal membrane oxygenation in pediatric patients with acute respiratory failure. Extracorporeal life support organization. Crit Care Med 23:1132–1139PubMedCrossRefGoogle Scholar
  64. 64.
    Wang CH, Chou CC, Ko WJ, Lee YC (2010) Rescue a drowning patient by prolonged extracorporeal membrane oxygenation support for 117 days. Am J Emerg Med 28:e5–e7Google Scholar
  65. 65.
    Dalton HJ, MacLaren G (2010) Extracorporeal membrane oxygenation in pandemic flu: insufficient evidence or worth the effort? Crit Care Med 38:1484–1485PubMedCrossRefGoogle Scholar
  66. 66.
    Scottish ECMO Expert Group (2009) Accessed 2 May 2011
  67. 67.
    Extracorporeal Life Support Organization (2010) H1N1 Registry. Accessed 17 March 2011
  68. 68.
    Pham T, Richard JCM, Brun-Buisson C, Reignier J, Brochard L (2011) Epidémie de grippe A H1N1 en réanimation: description du register REVA grippe SRLF. Accessed 29 March 2011
  69. 69.
    Mercat A, Richard JCM, Combes A, Chastre J, Ricard JD, Dreyfuss D, Brochard L (2011) SDRA lié a la grippe A (H1N1)-2009, Recommandations pour l’assistance respiratoire. Accessed 29 March 2011
  70. 70.
    Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C (2005) Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 294:813–818PubMedCrossRefGoogle Scholar
  71. 71.
    Haneya A, Phillip A, Mueller T, Lubnow M, Pfeifer M, Zink W, Hilker M, Schmid C, Hirt S (2011) Extracorporeal circulatory systems as a bridge to lung transplantation at remote transplant centers. Ann Thorac Surg 91:250–255PubMedCrossRefGoogle Scholar
  72. 72.
    Ricci D, Boffini M, Del Sorbo L, El Quarra S, Comoglio C, Ribezzo M, Bonato R, Ranieri VM, Rinaldi M (2010) The use of CO2 removal devices in patients awaiting lung transplantation: an initial experience. Transpl Proc 42:1255–1258CrossRefGoogle Scholar
  73. 73.
    Strueber M, Hoeper MM, Fischer S, Cypel M, Warnecke G, Gottlieb J, Pierre A, Welte A, Haverich A, Simon AR, Keshavjee S (2009) Bridge to thoracic organ transplantation in patients with pulmonary arterial hypertension using a pumpless lung assist device. Am J Transpl 9:853–857CrossRefGoogle Scholar
  74. 74.
    Fischer S, Simon AR, Welte T, Hoeper MM, Meyer A, Tessmann R, Gohrbandt B, Gottleib J, Haverich A, Strueber M (2006) Bridge to lung transplantation with the novel pumpless interventional lung assist device NovaLung. J Thorac Cardiovasc Surg 131:719–723PubMedCrossRefGoogle Scholar
  75. 75.
    Strueber M (2010) Extracorporeal support as a bridge to lung transplantation. Curr Opin Crit Care 16:69–73PubMedCrossRefGoogle Scholar

Copyright information

© Copyright jointly held by Springer and ESICM 2011

Authors and Affiliations

  • Graeme MacLaren
    • 1
    • 2
    Email author
  • Alain Combes
    • 3
  • Robert H. Bartlett
    • 4
  1. 1.Cardiothoracic ICUNational University HospitalSingaporeSingapore
  2. 2.Paediatric ICURoyal Children’s HospitalMelbourneAustralia
  3. 3.Service de Réanimation Médicale, Groupe Hospitalier Pitié-SalpêtrièreUniversité Pierre et Marie CurieParisFrance
  4. 4.University of MichiganAnn ArborUSA

Personalised recommendations