Extracorporeal membrane oxygenation in adults with acute respiratory distress syndrome

PURPOSE OF REVIEW: To evaluate the last 2 years' publications for evidence supporting use of extracorporeal membrane oxygenation (ECMO) for critically ill adults with acute respiratory distress syndrome (ARDS). RECENT FINDINGS: First, there are no new prospective studies comparing ECMO and other therapy in adults with ARDS. Second, the number of review articles and case descriptions published in the last 2 years suggests increased interest in ECMO. Third, recently published retrospective cohort studies analyzing patients from the H1N1 epidemic report conflicting conclusions. SUMMARY: Intensivists may have increased their utilization of ECMO. Credible evidence for mortality benefit of ECMO is lacking. A prospective randomized controlled trial designed to evaluate the efficacy of ECMO for ARDS is overdue.