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Extracorporeal Membrane Oxygenation for Nonneonatal Acute Respiratory Failure—Invited Critique
Robert J. Touloukian, MD
Arch Surg. 2009;144(5):432.
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The history of American surgery is replete with stories of initial failure, even abandonment of innovative technology, followed by eventual success through further improvisation, attention to detail, and persistence by the advocates that success was possible. The story of ECMO development is certainly a good example of the persistence principle, first in making neonatal ECMO a standard of care for the high-risk newborn with reversible pulmonary hypertension and congenital diaphragmatic hernia. Overall survival in this group now exceeds 70% based on recent Extracorporeal Life Support Organization data.
The overall experience with nonneonatal ECMO appears to be following a similar pattern of improving success based on this report by Nehra and colleagues from the Massachusetts General Hospital. The authors attribute the overall 53% survival to a better understanding of underlying respiratory disease, earlier intervention in selected patients, careful monitoring, and knowledge of the natural history of specific . . . [Full Text of this Article]
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Extracorporeal Membrane Oxygenation for Nonneonatal Acute Respiratory Failure: The Massachusetts General Hospital Experience From 1990 to 2008
Deepika Nehra, Allan M. Goldstein, Daniel P. Doody, Daniel P. Ryan, Yuchiao Chang, and Peter T. Masiakos
Arch Surg. 2009;144(5):427-432.
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