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Physiology of Extracorporeal Life Support (ECLS)

  • Chapter
Extracorporeal Life Support for Adults

Part of the book series: Respiratory Medicine ((RM,volume 16))

Abstract

Extracorporeal life support (ECLS) describes several advancing technologies of broadening scope that support severe cardiorespiratory dysfunction in critically ill patients. ECLS provides alternatives when mechanical ventilation does not suffice to deliver adequate oxygenation or carbon dioxide clearance. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) supports gas exchange in venous blood returning to the right heart. ECLS can also be configured to provide mechanical support of the failing circulation; veno-arterial extracorporeal membrane oxygenation (VA-ECMO) augments systemic blood flow utilising the extracorporeal blood pump. As patients can be critically dependent on these supports, a thorough understanding of the systems and their interaction with the body is essential in applying ECLS and in preventing or ameliorating problems that can arise.

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Notes

  1. 1.

    Occasionally the term αPCO2 is used in this equation to describe the total concentration of CO2 and carbonic acid; however, the concentration of the latter is orders of magnitude smaller than the former. Thus [CO2] can be calculated accurately from Henry’s Law without alteration of the solubility constant (Eq. 1.5).

  2. 2.

    Being electrical neutrality, the units are available charge (milli-equivalents per litre mEq·L−1); hence, the concentration of double valent ions is multiplied by 2 to account for their charge density. The multiplier of 1.8 for inorganic phosphate and 0.28 for albumin are approximations as the charge density for these weak acids varies slightly with pH. [z+] and [x−] refer to other unmeasured exogenous or endogenous cations and anions.

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Author information

Authors and Affiliations

  1. School of Public Health and Preventive Medicine, Monash University, Malvern East, VIC, Australia

    Matthew J. Brain MBBS (Hons), FRACP, FCICM, DDU

  2. The Alfred Intensive Care Unit, Melbourne, VIC, Australia

    Matthew J. Brain MBBS (Hons), FRACP, FCICM, DDU

  3. Department of Medicine, Launceston General Hospital, 274-280 Charles St, Launceston, TAS, 7250, Australia

    Matthew J. Brain MBBS (Hons), FRACP, FCICM, DDU

  4. ICU RCH, Department of Paediatrics UoM, Clinical Sciences Theme MCRI, Royal Children’s Hospital, Melbourne, VIC, Australia

    Warwick W. Butt FRACP, FCICM & Graeme MacLaren MBBS, FRACP, FCICM, FRCP, FCCP

  5. Paediatric Intensive Care Unit, 50 Flemington Road, Parkville, VIC, 3052, Australia

    Warwick W. Butt FRACP, FCICM & Graeme MacLaren MBBS, FRACP, FCICM, FRCP, FCCP

  6. Cardiothoracic ICU, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore

    Graeme MacLaren MBBS, FRACP, FCICM, FRCP, FCCP

Authors
  1. Matthew J. Brain MBBS (Hons), FRACP, FCICM, DDU
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  2. Warwick W. Butt FRACP, FCICM
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  3. Graeme MacLaren MBBS, FRACP, FCICM, FRCP, FCCP
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Corresponding author

Correspondence to Matthew J. Brain MBBS (Hons), FRACP, FCICM, DDU .

Editor information

Editors and Affiliations

  1. Division of Pulmonary Diseases, Critical Care, and Occupational Medicine, University of Iowa, Department of Internal Medicine, Iowa City, Iowa, USA

    Gregory A Schmidt

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Brain, M.J., Butt, W.W., MacLaren, G. (2016). Physiology of Extracorporeal Life Support (ECLS). In: Schmidt, G. (eds) Extracorporeal Life Support for Adults. Respiratory Medicine, vol 16. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-3005-0_1

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  • DOI: https://doi.org/10.1007/978-1-4939-3005-0_1

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-3004-3

  • Online ISBN: 978-1-4939-3005-0

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