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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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Metadata
- 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
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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
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