Iwashita Yoshiaki, Imai Hiroshi
Department of Emergency and Intensive Care Medicine, Mie University Medical School, Tsu-City, Mie 514-8507, Japan.
Cardiovasc Hematol Disord Drug Targets. 2015;15(1):46-56. doi: 10.2174/1871529x15666150108114429.
Acute respiratory distress syndrome (ARDS) is one of the major causes of ICU deaths. Extracorporeal lung assist (ECLA) has been used as a rescue therapy for most severe form of ARDS. However, its survival benefit had not been shown until CESAR trial in 2009. This has been because the concept of lung protective ventilation strategy had not yet known. Since CESAR trial, the clinical application of ECLA for ARDS as a method to achieve lung rest has wide spread. The effectiveness is further appreciated during the 2009 H1N1 influenza pandemic. The succeeded countries achieved building the transportation systems to collect ECLA patients. With the accumulating evidences of survival benefit, the long-term outcome such as pulmonary function and quality of life are in concern. PumplessECLA which is a newly developed form of ECLA is also reviewed. In this essay we will firstly review the basics of ARDS and ECLA. Then the historical development of ECLA evidences for ARDS are reviewed.
急性呼吸窘迫综合征（ARDS）是重症监护病房（ICU）死亡的主要原因之一。体外肺辅助（ECLA）已被用作最严重形式的ARDS的一种抢救治疗方法。然而，直到2009年的CESAR试验才显示出其生存益处。这是因为肺保护性通气策略的概念尚未为人所知。自CESAR试验以来，ECLA作为一种实现肺休息的方法在ARDS临床中的应用已广泛普及。在2009年甲型H1N1流感大流行期间，其有效性得到了进一步认可。成功的国家建立了收集ECLA患者的转运系统。随着生存益处证据的不断积累，诸如肺功能和生活质量等长期结果受到关注。同时也对新开发的无泵ECLA形式进行了综述。在本文中，我们将首先回顾ARDS和ECLA的基础知识。然后回顾ECLA用于ARDS的历史发展证据。
