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Ann Thorac Surg 1997;64:1581-1582
© 1997 The Society of Thoracic Surgeons

Editorial

Is Extracorporeal CO2Removal an Option in the Treatment of Adult Respiratory Distress Syndrome?

Jean Deslauriers, MD, John A. Awad, MD,.PhD

Centre de Pneumologie de l'Hôpital Laval, Ste-Foy, Quebec, Canada

The first 20% of the full text of this article appears below.

Despite the many technical advances that have occurred in the management of assisted ventilation, the mortality of adult respiratory distress syndrome (ARDS) is still greater than 60% and the mechanical ventilation necessary to deliver adequate tidal volumes with high peak airway pressures has been shown to further aggravate the underlying pulmonary condition or even contribute to the specific lung pathology seen in ARDS [1]. Thus conventional management of these patients still presents a problem, and extracorporeal membrane oxygenation (ECMO) in which the major part of gas exchange is accomplished by the extracorporeal circulation has been promoted as a solution. Unfortunately, previous controlled studies carried out in adult patients with life-threatening ARDS have shown no improvement in survival with ECMO when compared with conventional techniques of mechanical ventilation [2]. Recent developments in the management of extracorporeal circulation have helped to increase survival in the adult population, but the results are still far below the 90% survival rate obtained in neonates who require ventilatory support through the use of ECMO.

See also page 1599.

Although most reports . . . [Full Text of this Article]


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Total Arteriovenous CO2 Removal: Simplifying Extracorporeal Support for Respiratory Failure
Robert L. Brunston, Jr, Joseph B. Zwischenberger, Weike Tao, Victor J. Cardenas, Jr, Daniel L. Traber, and Akhil Bidani
Ann. Thorac. Surg. 1997 64: 1599-1604. [Abstract] [Full Text]





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