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Kim, Choi, and Hong: The Treatment of Adult Respiratory Distress Syndrome (ARDS) Using Extracorporeal Membrane Oxygenation (ECMO)
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Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(1): 1-7.

Published online: 30 January 2012

DOI: https://doi.org/10.4046/trd.2012.72.1.1

The Treatment of Adult Respiratory Distress Syndrome (ARDS) Using Extracorporeal Membrane Oxygenation (ECMO)

Go Woon Kim, M.D.1, Eun Young Choi, M.D.2, Sang Bum Hong, M.D., Ph.D.1

1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Division of Pulmonary and Critical Care Medicine, Yeungnam University College of Medicine, Daegu, Korea.

Address for correspondence: Sang Bum Hong, M.D., Ph.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3893, Fax: 82-2-3010-6968, sbhong@amc.seoul.kr

Co-correspondence: Go Woon Kim, M.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-1788, Fax: 82-2-3010-6968, taria@nate.com

Received 5 December 2011       Revised 5 December 2011       Accepted 8 December 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal CO2 removal (ECCO2R), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

Keywords: Respiratory Distress Syndrome, Adult, Extracorporeal Membrane Oxygenation, Extracorporeal Circulation, Intensive Care Unit

Figures and Tables

Figure 1
(A) Recirculation phenomenon. (B) Dual-lumen cannula. This figure was reprinted from NEJM 2011:365:1905-14.
trd-72-1-g001
Table 1
ECMO on adult respiratory failure
trd-72-1-i001

ECMO: extracorporeal membrane oxygenation; ANC: absolute neutrophil count.

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