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To assess whether we should use early (rather than rescue) extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS), French investigators randomized patients to receive either venovenous ECMO or routine care within 7 days of intubation. All patients received low tidal volume ventilation. At enrollment, nearly two thirds of patients had been treated with prone positioning, and almost all had received neuromuscular blockade. Most patients who were randomized to ECMO (96%) were cannulated within 3 hours of enrollment.
The trial was stopped after 240 of 331 planned patients were enrolled, when an interim analysis indicated futility. Sixty-day mortality was not significantly lower in the ECMO …