ECMO in severe acute respiratory distress syndrome

Abstract

As summarised last year in a Comment in The Lancet Respiratory Medicine,1 four randomised trials2–5 of extracorporeal membrane oxygenation (ECMO) have been done in patients with severe acute respiratory distress syndrome (ARDS) in the past 40 years. The 1979 and 1994 trials2,3 did not include a lung-protective ventilation strategy for patients in their control groups because they were done before publication of the US National Heart, Lung, and Blood Institute's ARDS Network-sponsored trial,6 which was published in 2000 and showed a major reduction in mortality with a low tidal volume and plateau pressure limited ventilation strategy.