ECMO for severe ARDS: systematic review and individual patient data meta-analysis
Combes A, Peek GJ, Hajage D, et al., 2020 · 2 studies included
Summary
Individual-patient-data meta-analysis of the two modern randomized trials, CESAR and EOLIA (429 patients), comparing an ECMO strategy with conventional management for severe ARDS.
Conclusion
At 90 days, mortality was 36% (77/214) in the ECMO group versus 48% (103/215) in controls (RR 0.75, 95% CI 0.60-0.94; P=0.013). Interpretation must account for rescue crossover from control to ECMO and differences between the trial strategies.
Clinical Context & Relevant Topics (2)
Disease ReferenceSpecialist-level VV/VA ECMO bedside management: selection, cannulation, gas exchange, hemodynamics, anticoagulation, circuit troubleshooting, organ support, ultrasound, ECPR, weaning and decannulation.
Acute, diffuse inflammatory lung injury causing hypoxemia and bilateral infiltrates not fully explained by cardiac failure or fluid overload.