Management Strategies for Severe Respiratory Failure: As Extracorporeal Membrane Oxygenation Is Being Considered

Bharat Awsare; Justin Herman; Michael Baram

doi:10.1016/j.ccc.2017.06.003

Management Strategies for Severe Respiratory Failure: As Extracorporeal Membrane Oxygenation Is Being Considered

Crit Care Clin. 2017 Oct;33(4):795-811. doi: 10.1016/j.ccc.2017.06.003. Epub 2017 Jul 29.

Authors

Bharat Awsare¹, Justin Herman¹, Michael Baram²

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, USA.
² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Thomas Jefferson University, 834 Walnut Street, Suite 650, Philadelphia, PA 19107, USA. Electronic address: Michael.Baram@jefferson.edu.

PMID: 28887928
DOI: 10.1016/j.ccc.2017.06.003

Abstract

Pulmonary and critical care physicians must be facile in recognition and management of patients with acute respiratory distress syndrome (ARDS). Part of the current critical care knowledge base must include an understanding of how extracorporeal membrane oxygenation fits into the paradigm of ARDS management without using it as a "salvage therapy." This article provides a basic understanding of the evolution of ARDS to multiple organ dysfunction syndrome, recognizing benefits and limits of rescue therapies, indications and contraindications of extracorporeal membrane oxygenation, and coordination of care for severe respiratory failure.

Keywords: ARDS; ECMO; Mechanical ventilation; Multiorgan failure; Respiratory failure.

Publication types

Review

MeSH terms

Critical Care
Extracorporeal Membrane Oxygenation / methods*
Humans
Multiple Organ Failure / therapy*
Respiratory Distress Syndrome / therapy*
Respiratory Insufficiency / therapy*
Salvage Therapy / methods