{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T19:47:57Z","timestamp":1782503277598,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T00:00:00Z","timestamp":1611532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Modern extracorporeal life\u2010support (ECLS) technology has been successfully utilized to treat patients with diffuse alveolar damage (DAD) and diffuse alveolar hemorrhage (DAH); however, reports in the literature remain scarce. We sought to pool existing evidence to better characterize ECLS use in these patients. An electronic search was conducted to identify all studies in the English literature reporting the use of ECLS for DAD\/DAH. Thirty\u2010two articles consisting of 38 patients were selected, and patient\u2010level data were extracted and pooled for analysis. Median patient age was 36 [IQR: 27, 48] years, and the majority (63.2%) were female. Most common etiological factors included granulomatosis with polyangiitis (8\/38, 21.1%), systemic lupus erythematosus (8\/38, 21.1%), Goodpasture's syndrome (4\/38, 10.5%), and microscopic polyangiitis (4\/38, 10.5%). Immunologic markers included anti\u2010neutrophil cytoplasmic antibody (ANCA) in 15\/38 (39.5%), anti\u2010nuclear antibody (ANA) in 6\/38 (15.8%), and anti\u2010glomerular basement membrane (anti\u2010GBM) antibodies in 4\/38 (10.5%). DAH was present in 32\/38 (84.2%) of cases and DAD without evidence of DAH was present in 6\/38 (15.8%) of cases. ECLS strategies included extracorporeal membrane oxygenation of veno\u2010venous type (VV\u2010ECMO) in 28\/38 (73.7%), veno\u2010arterial type (VA\u2010ECMO) in 5\/38 (13.2%), and one case of right ventricular assist device with oxygenator (RVAD\u2010ECMO). Heparin was utilized in 18\/38 (47.4%) of cases with no difference in use between DAH versus no DAH (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.46) or VA\u2010 versus VV\u2010ECLS (<jats:italic>P<\/jats:italic>\u00a0=\u00a01). Median duration of ECLS was 10 [5, 14] days. Pre\u2010 versus post\u2010ECLS comparison of blood gases showed improvement in median PaO<jats:sub>2<\/jats:sub> (49 [45, 59] mm Hg vs. 80 [70, 99] mm Hg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), PaO2:FiO<jats:sub>2<\/jats:sub> ratio (48.2 [41.4, 54.8] vs. 182.0 [149.4, 212.2], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), and pulse oximetry values (76% [72, 80] vs. 96% [94, 97], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.086). Overall, 94.7% (36\/38) of patients survived to decannulation while 30\u2010day mortality was 10.5% (4\/38) with no differences between VA\u2010 and VV\u2010ECMO (<jats:italic>P<\/jats:italic>\u00a0=\u00a01 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.94, respectively). DAD\/DAH occurs in a younger, predominantly female population, and tends to be associated with systemic autoimmune processes. ECLS, independent of its type, appears to result in favorable short\u2010term survival.<\/jats:p>","DOI":"10.1111\/aor.13861","type":"journal-article","created":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T09:01:54Z","timestamp":1605430914000},"page":"559-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Utilization of extracorporeal life support for diffuse alveolar damage and diffuse alveolar hemorrhage: A systematic review"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8888-0983","authenticated-orcid":false,"given":"Haritha G.","family":"Reddy","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6870-8211","authenticated-orcid":false,"given":"Elizabeth J.","family":"Maynes","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhiraj","family":"Saxena","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"Austin","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9128-1084","authenticated-orcid":false,"given":"Thomas J.","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc N.","family":"Gadda","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawar N.","family":"Al\u2010Rawas","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Baram","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat K.","family":"Awsare","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Todd","family":"Massey","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4357-3533","authenticated-orcid":false,"given":"Vakhtang","family":"Tchantchaleishvili","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery Thomas Jefferson University Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"ELSO Guidelines Patient Care Practice Guidelines[Internet] [cited 2020 Jul]. Available from:https:\/\/www.elso.org\/Portals\/0\/ELSO\u00a0Guidelines\u00a0For\u00a0Adult\u00a0Respiratory\u00a0Failure\u00a01_4.pdf"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/138.3.720"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201211-1981OC"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2013.74.4.151"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2012.01551.x"},{"issue":"23","key":"e_1_2_8_7_1","first-page":"2526","article-title":"Acute respiratory distress syndrome","volume":"307","author":"Force AD","year":"2012","journal-title":"JAMA"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197203232861204"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800385"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201609-728PS"},{"issue":"3","key":"e_1_2_8_11_1","first-page":"172","article-title":"A meta\u2010analysis of complications and mortality of extracorporeal membrane oxygenation","volume":"15","author":"Zangrillo A","year":"2013","journal-title":"Crit Care Resusc"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201311-2023OC"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.002394"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00063198-200009000-00008"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-018-2098-6"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.12746\/swrccc.v3i9.186"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200007000-00003"},{"issue":"1","key":"e_1_2_8_18_1","first-page":"605","article-title":"Prevalence and significance of haematological abnormalities in patients with systemic lupus erythematosus","volume":"80","author":"Nossent JC","year":"1991","journal-title":"Q J Med"},{"issue":"2","key":"e_1_2_8_19_1","first-page":"145","article-title":"Extracorporeal membrane oxygenation in diffuse alveolar hemorrhage secondary to systemic lupus erythematosus","volume":"6","author":"Claudio CP","year":"2014","journal-title":"J Clin Med Res"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201605-364SR"},{"key":"e_1_2_8_21_1","volume-title":"Murray and Nadel\u2019s Textbook of respiratory medicine","year":"2016"},{"key":"e_1_2_8_22_1","first-page":"627","article-title":"Successful application of extracorporeal membrane oxygenation due to pulmonary hemorrhage secondary to granulomatosis with polyangiitis","volume":"7","author":"Hohenforst\u2010Schmidt W","year":"2013","journal-title":"Drug Des Devel Ther"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2012.01101.x"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13861","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.13861","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T03:47:24Z","timestamp":1693367244000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.13861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,25]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1111\/aor.13861"],"URL":"https:\/\/doi.org\/10.1111\/aor.13861","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,25]]},"assertion":[{"value":"2020-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}