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The Conventional Ventilatory Support vs. Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure (CESAR) Trial was a UK-based multicenter RCT aiming to evaluate the safety, efficacy and cost effectiveness of ECMO compared to conventional mechanical ventilation in adults with severe but reversible respiratory failure. [63]
The last formally published ELSO Registry report was in 2017, and contained clinical characteristics, complications, and outcomes of 78,397 patients supported with ECMO. [10] Demonstrating the rapid growth of ECMO, at the beginning of 2020, the ELSO Registry contained information on 129,037 patients from 435 member centers across the world. [11]
Similarly as with adults ECMO is only indicated if reversal of the pathology for example with cardiac transplantation, is feasible. [27] When it comes to the consideration of the withdrawal of ECMO, unlike in adult populations parents are encouraged to make the final decision with guidance from the treating physicians.
Although the terminology of "adult respiratory distress syndrome" has at times been used to differentiate ARDS from "infant respiratory distress syndrome" in newborns, the international consensus is that "acute respiratory distress syndrome" is the best term because ARDS can affect people of all ages. [6]
A MAQUET hollow fiber membrane oxygenator. A membrane oxygenator is a device used to add oxygen to, and remove carbon dioxide from the blood.It can be used in two principal modes: to imitate the function of the lungs in cardiopulmonary bypass (CPB), and to oxygenate blood in longer term life support, termed extracorporeal membrane oxygenation (ECMO).
The Extracorporeal Life Support Organization (ELSO) maintains a registry of outcomes for this technology, and as of September 2020 it has been used in less than 120,000 patients over 435 ECMO centers worldwide with 40% mortality for adult respiratory patients.
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Extracorporeal life support (ECLS), is a set of extracorporeal modalities that can provide oxygenation, removal of carbon dioxide, and/or circulatory support, excluding cardiopulmonary bypass for cardiothoracic or vascular surgery.