Vascular access for extracorporeal life support: tips and tricks

The contemporary extracorporeal life support (ECLS) techniques are the results of more than a century of technical innovations, scientific knowledges, and clinical practices. The proof of concept of both the ECLS and the extracorporeal hematosis has been established through different positive clinical experiences in adults and neonatal cohorts (1-4). The concept of ECLS is the association of: (I) a short to mid term mechanical extracorporeal support; (II) the extracorporeal clearance of carbon dioxide (CO2); (III) the extracorporeal oxygenation according the ECLS flow; and (IV)—depending the configuration of the circuit—the extracorporeal cardiocirculatory support. The aim of the ECLS is to supply the failing respiratory and/or cardiocirculatory system(s) until: the recovery (bridge to recovery), the transplantation (bridge to transplantation), the change to another ECLS device/configuration (bridge to bridge), or the change of cares strategy (bridge to decision)