ECMO for Severe ARDS

The acute respiratory distress syndrome (ARDS), which is characterized by severe hypoxemic respiratory failure, affects as many as 10% of patients in the intensive care unit and is a common reason for the use of therapeutic mechanical ventilation. 1 On the basis of results of landmark clinical trials, there is substantial consensus around an initial approach to ARDS that combines invasive mechanical ventilation with limited tidal volumes, 2 the use of positive end-expiratory pressure (PEEP) to prevent derecruitment (the collapse of small airways and alveoli), 3 and conservative fluid management. 4 In patients with severe ARDS, defined as a ratio of partial pressure of... Copyright © 2018 Massachusetts Medical Society.