Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome
Citation: Tillmann BW, Klingel ML, Iansavichene AE, et al. Extracorporeal membrane oxygenation (ECMO) as a treatment strategy for severe acute respiratory distress syndrome (ARDS) in the low tidal volume era: a systematic review. Journal of critical care. 2017 Oct 1;41:64-71.
What is this? Some patients with COVID-19 will become critically ill and need help with their breathing with, for example, extracorporeal membrane oxygenation (ECMO), which is a form of life support that targets the heart and lungs.
In this systematic review, the authors searched for randomized trials and observational studies of adult patients with severe acute respiratory distress syndrome, comparing ECMO and low tidal volume mechanical ventilation to low tidal mechanical ventilation alone. They did not restrict their searches by language of publication but only studies with at least 10 patients were eligible. They included one randomized trial and 26 observational studies (total: 1674 participants) and rated the overall quality of evidence included in the review as low.
What was found: There was no clear difference in overall mortality between ECMO and other treatments for severe acute respiratory distress syndrome.
The incidence of adverse events varied greatly between the included studies.
Overall, there was a high level of variation within the studies which limited comparisons and interpretation.
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