Extracorporeal support in ARDS with and without mechanical ventilation

Extra Corporeal Membrane Oxygenation (ECMO) is a temporary artificial extracorporeal support of the respiratory and/or cardiac system used for the treatment of cardiopulmonary failure refractory to conventional therapies. More than 1000 papers on ECMO published between January 2009 and May 2011 (PubMed research) clearly indicate a renewed interest in the technique, initially triggered by the CESAR trial publication and the recent H1N1 flu epidemics. Indeed, during the epidemic, the number of patients with ARDS that were not safely treatable with current clinical settings of mechanical ventilation (6-8 ml/kg tidal volume normalized on ideal body weight and plateau pressure lower than 30-35 cmH2O) and therefore received extracorporeal respiratory support, greatly increased.