Until the last two decades, use of bypass machine outside of cardiac surgery has developed to support haemodynamic needs in procedures where circulation is compromised or ventilation is impossible. The more recent development of circulatory support techniques has gradually replaced the heart-lung machine with simpler equipment. In addition, these devices are commonly used in the event of failure to wean from bypass machine after complex cardiac procedures or when the heart is momentarily unable to function (cardiogenic shock, sepsis, fulminant myocarditis, pulmonary embolism).
There are several application areas for ECC outside of cardiac surgery.
- Neurosurgery: excision of aneurysms under hypothermia;
- Inferior vena cava surgery: renal tumour, liver transplantation;
- Tracheobronchial tree surgery, lung transplantation;
- Thoracoabdominal aorta surgery (see Chapter 18, Spinal cord protection);
- Haemodynamic support in acute ventricular failure (see Extracorporeal Assistance);
- Rewarming of hypothermic accident victims (see Rewarming ECC);
- Isolated limb infusion in oncology (see Limb infusion).
© CHASSOT PG, GRONCHI F, April 2008, last update, December 2019