Will ExtraCorporeal Support Replace the Ventilator?

Will extracorporeal support replace the ventilator? Traditional ECMO has focused on providing life support for the sickest of the sick once conventional ventilation methods are maximized. But what about using minimally invasive or smaller extracorporeal systems to provide support that would prevent patients from needing to be intubated? Or what if extracorporeal support was used to wean very sick patients off of the ventilator. Is is feasible that we advance the safety and efficacy of extracorporeal support to significantly reduce or even eliminate the need for invasive positive pressure ventilation?

Sklar et al recently published in Intensive Care Medicine June 2015 an abstract indicating the possibility of beneficial use of extracorporeal support for selective patients to either assist in weaning patients off of the ventilator or preventing them from needing invasive positive pressure ventilation. Their abstract also points out that complications of extracorporeal support where not benign.

A company called Alung Technologies has been perfecting a device what they refer to as The Hemolung® RAS to provide Respiratory Dialysis®. As stated on their web site…”A simple, minimally invasive approach to extracorporeal CO2 removal for patients with acute hypercapnic respiratory failure.” Hemolung is not yet FDA approved for open use in the United States. But it has been used in over 75 hospitals in at least 19 countries. It has reportedly been used at least twice in the United States under the FDA’s emergency use regulation.

So maybe the question “Will extracorporeal support replace the ventilator?” isn’t as far fetched as one might think.

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