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).
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In critical care, decisional conflict may be particularly pronounced.
“In critical care, where life-altering decisions must be made rapidly, decisional conflict may be particularly pronounced4.”
From Decisional conflict among Chinese family caregivers prior to ECMO initiation: a cross-sectional study (2025) · cites this paper as [4]
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Self-citation
- Authors
- Brodie, D., & Bacchetta, M.
- Affiliations
- NewYork–Presbyterian Hospital (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2011-11-17
- Volume
- 365
- Issue
- 20
- Pages
- 1905-1914
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2037145800
- Cited by
- 836
- References
- 76
- Citations by year
- 2026: 19 · 2025: 33 · 2024: 36 · 2023: 36 · 2022: 42 · 2021: 64 · 2020: 65 · 2019: 67 · 2018: 58 · 2017: 81 · 2016: 89 · 2015: 61 · 2014: 83 · 2013: 56 · 2012: 40
- FWCI
- 9.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- extracorporeal membrane oxygenation, acute respiratory distress syndrome, community-acquired pneumonia, pneumococcal pneumonia, hypoxemic respiratory failure, mechanical ventilation, prone positioning, neuromuscular blockade, adult patients
- MeSH terms
- Adult, Hypoxia, Female, Humans, Pneumonia, Pneumococcal, Respiratory Distress Syndrome, Extracorporeal Membrane Oxygenation, Practice Guidelines as Topic, Community-Acquired Infections
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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