title: Extracorporeal membrane oxygenation for ARDS in adults.
abstract: A 41-year-old woman presents with severe community-acquired pneumococcal pneumonia. Chest radiography reveals diffuse bilateral infiltrates, and hypoxemic respiratory failure develops despite appropriate antibiotic therapy. She is intubated and mechanical ventilation is initiated with a volume- and pressure-limited approach for the acute respiratory distress syndrome (ARDS). Over the ensuing 24 hours, her partial pressure of arterial oxygen (Pao2) decreases to 40 mm Hg, despite ventilatory support with a fraction of inspired oxygen (Fio2) of 1.0 and a positive end-expiratory pressure (PEEP) of 20 cm of water. She is placed in the prone position and a neuromuscular blocking agent is administered, without improvement in her Pao2. An intensive care specialist recommends the initiation of extracorporeal membrane oxygenation (ECMO).
authors.affiliation: Columbia University College of Physicians and Surgeons, and New York-Presbyterian Hospital, New York, NY 10032, USA. hdb5@columbia.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Brodie
authors.forename: Matthew
authors.initials: M
authors.lastname: Bacchetta
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000150:complications; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D011018:Pneumonia, Pneumococcal / Q000150:complications; D017410:Practice Guidelines as Topic; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000628:therapy*