Is ECMO Ready for the Big Time?

Mortality in acute respiratory distress syndrome (ARDS) can be as high as 60%, and survivors are often left with severe disabilities and require further care. Conventional high-pressure treatment and high oxygen concentrations can be toxic to the lungs. Extracorporeal membrane oxygenation (ECMO), which provides gas exchange while bypassing the lungs, is an emerging treatment for ARDS. In a multicenter U.K. study, researchers randomized 180 unconscious, intubated, and ventilated patients (age range, 18–65) with severe ARDS (Murray score >3.0 or pH <7.20) to referral to a single ECMO-capable center or to receive continued standard ventilator management. Patients who required high-pressure (>30 cm H₂O) or high FiO₂ (>80%) ventilation for more …