What is the role of extracorporeal membrane oxygenation (ECMO) in the treatment of respiratory failure?

Updated: Apr 07, 2020
  • Author: Ata Murat Kaynar, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Answer

Extracorporeal membrane oxygenation (ECMO) may be more effective than conventional management for patients with severe but potentially reversible respiratory failure.

Peek et al found that survival without severe disability was significantly higher in patients who were transferred to a single specialized center for consideration of ECMO. [7] In a randomized, controlled trial in 180 patients either with a Murray lung injury score of 3.0 or higher or with uncompensated hypercapnia and a pH lower than 7.20 despite optimal conventional treatment, 36.7% of patients in the ECMO arm had died or were severely disabled 6 months after randomization, compared with 52.9% of patients in the conventional treatment arm.

Although average total costs were more than twice as high for ECMO than for conventional care in this study, lifetime quality-adjusted life-years (QALYs) gained were 10.75 for the ECMO group and 7.31 for the conventional group. [7]


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