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ECMO for ARDS and Refractory Hypoxemia
- Extracorporeal membrane oxygenation (ECMO), or extracorporeal life support (ECLS), is increasingly being used for a variety of cardiac and pulmonary conditions.
- Venovenous ECMO (VVE) should be considered in the treatment of patients with profound gas-exchange abnormalities that are refractory to accepted standards in ventilator management.
- Although indications vary slightly by institution, general indications for VVE include:
- Severe hypoxemia: PaO2/FiO2 < 80 despite high levels of PEEP for at least 6 hours
- Uncompensated hypercapnia with pH < 7.15
- Excessively high plateau pressures (> 45 cm H20)
References
Brodie D, Bacchetta M. Extracorporeal membrane oxygenation for ARDS is adults. NEJM 2011;365:1905-14.