ASAIO journal : a peer-reviewed journal of the American Society for Artificial Internal Organs
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Review Historical Article
The evolution of extracorporeal life support as a bridge to lung transplantation.
The use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation was reported for the first time more than three decades ago; nevertheless, its use in lung transplantation was largely abandoned because of poor patient survival and frequent complications. The outcomes of patients bridged to lung transplantation using ECMO have substantially improved in the last 5 years. Recent advances in extracorporeal life support technology now allow patients with end-stage lung disease to be successfully supported for prolonged periods of time, preventing the use of mechanical ventilation and facilitating physical rehabilitation and ambulation while the patients awaits lung transplantation. This review briefly describes the evolution of ECMO use in lung transplantation and summarizes the available technology and current approaches to provide ECMO support.
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Allogeneic transfusion, or transfusion of blood banked blood has been associated with a litany of complications for the recipient. These complications plus associated cost has led to the development of a concept called "patient blood management," which recognizes that allogeneic transfusion may be necessary; however, all effort should be expended at minimizing its need. ⋯ This process can take place in the intraoperative or postoperative period. This article describes the technology, how it works, and how to maximize the utility of the system.