Supporting the circulation, but injuring the brain: the (still unsolved) threat and paradox of extracorporeal life support
Abstrakt
The benefits of extracorporeal life support (ECLS) in the setting of refractory cardiac and pulmonary compromise have been repetitively reported or remain still under active investigation (cardiac arrest, cardiogenic and septic shock). Recent fast developments in technology and increased experience have been instrumental to the surge of use of such a temporary cardio-respiratory support worldwide.
However, despite the observed positive impacts on patient outcome, the complexity of the ECLS-patient interaction represents an inevitable source of adverse events, apparently and intimately related to the inherent features of the ECLS application and run. Adverse events are, therefore, often present in ECLS patients, ranging from trivial and easily manageable to severe shortcomings, even contributing to unfavorable patient outcome.
This contradictory scenario is most overtly represented by the neurological complications not unfrequently observed during ECLS runs.