What is the evidence for the use of ECMO in ARDS?

Intervention
Population
Conclusion

RCT: CESAR

Peek et al
BMC Health Serv Res (2006)

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  • Management in tertiary respiratory centre (75% receiving ECMO) vs. conventional ventilation in a referral centre
  • 180 patients with ARDS (Murray score >3)
  • Management in a tertiary centre with the availability of ECMO improved 6-mortality (63% vs. 47%, p=0.03)
The Bottom Line Review

RCT: EOLIA

Combes et al
NEJM (2018)

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  • Early initiation of ECMO vs. conventional ventilation with possibility for ECMO as rescue therapy (28% of group)
  • 249 patients with “very severe” ARDS as defined by clinical criteri
  • No significant improvement with early ECMO initiation (35% vs 46%, p=0.09)
The Bottom Line Review