The Role of Extracorporeal Life Support in Thoracic Surgery

Purpose of Review Extracorporeal life support (ECLS) is a widely used potential treatment option in patients with severe respiratory or cardiac failure with increasing significance. Routine perioperative application of ECLS is applied in cardiac and rare in thoracic surgery. This review will address the extracorporeal membrane oxygenation (ECMO) technology and basic concepts, the indications in thoracic surgery, and the intraoperative management of ECMO during surgery. The most common challenges and complications, the postoperative concept, and additional forms of support will be discussed. Recent Findings Technological advances in ECMO components may allow complex thoracic surgical procedures in patients in whom one-lung ventilation cannot be carried out safely without risk of hypoxia or right ventricular failure. Summary The indications of ECLS in thoracic surgery besides lung transplantation are mainly airway resection and reconstructive surgery in patients with obstructive tracheobronchial airway diseases. Rare indications are lung surgery in patients with poor pulmonary reserve and difficulty or impossibility of one-lung ventilation. The intraoperative management of ECMO during thoracic surgery needs professional expertise.