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Awake extracorporeal membrane oxygenation in immunosuppressed patients with severe respiratory failure—a stretch too far?

  
@article{JTD29430,
	author = {Kiran Shekar and Darryl Abrams and Matthieu Schmidt},
	title = {Awake extracorporeal membrane oxygenation in immunosuppressed patients with severe respiratory failure—a stretch too far?},
	journal = {Journal of Thoracic Disease},
	volume = {11},
	number = {7},
	year = {2019},
	keywords = {},
	abstract = {The use of rescue extracorporeal membrane oxygenation (ECMO) in immunocompromised patients with acute respiratory distress syndrome (ARDS) is increasing with 5% to 31% of patients receiving ECMO (1,2) in recent studies. In the recently published ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) trial, 22% of the recruits were identified as immunosuppressed and the sixty-day mortality of this sub-population was 56% and 78% in the ECMO and the control groups, respectively (3). Even though a post-hoc analysis of this small subgroup may not be definitive evidence for or against ECMO use in this population, it is important to note that “salvage” VV-ECMO (4) in the immunosuppressed is a futile exercise. However, this raises two important questions beyond crude mortality of this population: (I) might this population benefit from early VV-ECMO to liberate them from invasive mechanical ventilation (IMV) as soon as feasible? and (II) can IMV be avoided altogether in this cohort?},
	issn = {2077-6624},	url = {http://jtd.amegroups.com/article/view/29430}
}