ECMO for Severe ARDS

The acute respiratory distress syndrome (ARDS), which is characterized by severe hypoxemic respiratory failure, affects as many as 10% of patients in the intensive care unit and is a common reason for the use of therapeutic mechanical ventilation.1 On the basis of results of landmark clinical trials, there is substantial consensus around an initial approach to ARDS that combines invasive mechanical ventilation with limited tidal volumes,2 the use of positive end-expiratory pressure (PEEP) to prevent derecruitment (the collapse of small airways and alveoli),3 and conservative fluid management.4 In patients with severe ARDS, defined as a ratio of partial pressure of . . .