Effectiveness of extracorporeal membrane oxygenation when conventional ventilation fails: Valuable option or vague remedy?

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27 Citations (Scopus)

Abstract

The mortality and morbidity of patients with severe acute respiratory distress syndrome (ARDS) remains high despite the advances in intensive care practice. The low-tidal-volume ventilation strategy (ARDS net protocol) has been shown to be effective in improving survival. Unfortunately, however, some patients have such severe ARDS that they cannot be managed with the ARDS net strategy. In these patients, rescue therapies such as high-frequency ventilation, prone ventilation, nitric oxide, and extracorporeal membrane oxygenation (ECMO) are considered. The CESAR trial has shown that an ECMO-based protocol improved survival without severe disability as compared with conventional ventilation. The recent increased incidence of severe respiratory failure due to H1N1 influenza pandemic has led to an increased use of ECMO. Although several reports showed ECMO use to be encouraging, some scepticism remains. In this article, we reviewed the usefulness of ECMO in patients with severe ARDS in the light of current evidence.

Original languageEnglish
Pages (from-to)192-198
Number of pages7
JournalJournal of Critical Care
Volume27
Issue number2
DOIs
Publication statusPublished - Apr 2012
Externally publishedYes

Keywords

  • ARDS
  • ECMO
  • Respiratory failure

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