Popis: |
Extracorporeal membrane oxygenation (ECMO) is an established life-supporting modality that can be used to support gas exchange while the lungs recover in patients with acute respiratory distress syndrome (ARDS) refractory to optimized mechanical ventilation. Eligible patients include those with reversible respiratory failure, usually aged less than 65 years. Ideally, ECMO should be initiated before the patient has received more than 7 days of ventilation as lung recovery can be delayed in patients who have received prolonged ventilation prior to ECMO. These benefits are only achieved through complementary use of ECMO with lung-protective ventilation strategies. Adjunctive measures such as prone positioning, short-term paralysis, liberation from sedation, treatment of pneumonia, nutrition, and mobilization are also helpful. Successful ECMO utilization requires careful patient selection and attention to the details of treatment in order to optimize outcomes and minimize risk of catastrophic complications. |