IMR Press / RCM / Volume 22 / Issue 4 / DOI: 10.31083/j.rcm2204145
Open Access Review
Ambulatory home wearable lung: progress and future directions
Show Less
1 Department of Surgery, Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA

Academic Editor: Alberto Palazzuoli and Francesco Onorati

Rev. Cardiovasc. Med. 2021, 22(4), 1405–1411; https://doi.org/10.31083/j.rcm2204145
Submitted: 7 October 2021 | Revised: 1 November 2021 | Accepted: 12 November 2021 | Published: 22 December 2021
(This article belongs to the Special Issue Interventions for the failing left ventricle)
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

Extracorporeal life support (ECLS) was first implemented as an extension of cardiopulmonary bypass technology. The early use of ECLS in patients with acute respiratory distress syndrome (ARDS) was discouraging, likely due to limitations of technology and understanding of the disease process. However, over the last decade, there has been a rapid expansion in ECLS use. This ”rebirth” in 2009 was largely driven by the need for ECLS during the Influenza A subtype H1N1 pandemic and the results of the conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR) trial showing improved outcomes in patients with ARDS on ECLS compared to traditional management. Along with the increase in overall use of ECLS, there has been an increase in the number of patients with lung failure who are on long-term support, either awaiting lung recovery or transplantation. Many of these patients are awake, participating in physical rehabilitation, and even ambulating while supported with ECLS. Given the recent advances in patient care, and improvements in ECLS technology, the movement towards home for stable patients supported with ECLS may be on the horizon. Patients supported with ventricular assist devices (VAD) underwent a similar transition towards home in the 1990s, before which they were hospital bound. The road to an ambulatory home wearable lung will likely mirror that pathway. This review will give a brief overview of the transition of VAD patients out of the hospital, the history of ECLS, the current state of ECLS for lung failure, new and upcoming ECLS technology, and hurdles on the road home for ECLS patients.

Keywords
Acute respiratory distress syndrome
Ambulatory devices
End-stage lung disease
Extracorporeal life support
Extracorporeal membrane oxygenation
Respiratory failure
Share
Back to top