Position Paper for the Organization of Extracorporeal Membrane Oxygenation Programs for Acute Respiratory Failure in Adult Patients
American Journal of Respiratory and Critical Care Medicine
Online, July 2014
See full paper here.
The aim of this paper is to provide physicians, ECMO center directors and coordinators, hospital directors, health care organizations, regional, national and international policy makers a description of the optimal approach to organizing ECMO programs for ARF in adult patients. Importantly, this will help ensure that ECMO is delivered safely and proficiently, such that future observational and randomized clinical trials assessing this technique may be performed by experienced centers under homogeneous and optimal conditions.
Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO
This is a multi-centre, open-label, descriptive pharmacokinetic (PK) study.
ventiLatIon management oF patients with Extracorporeal membrane oxyGenation for Acute Respiratory Distress Syndrome
LIFEGARDS is a multicenter, observational study assessing the mechanical ventilation management of patients with ARDS undergoing ECMO, in a worldwide population over a one-year period.
HEparin Low-dose Protocol in ECMO Patients
HELP ECMO is a single center, randomized, controlled feasibility study assessing the use of low-dose heparin, as compared with full-dose heparin, in critically ill patients undergoing ECMO.
ECMO to rescue Lung Injury in severe ARDS
EOLIA is a multicenter, international, randomized, controlled trial run by the REVA network and endorsed by the International ECMO Network. The study hypothesizes that ECMO, instituted early after the diagnosis of very severe ARDS (P:F < 80), would lower the morbidity and mortality associated with this syndrome.
pRotective vEntilation with veno-venouS lung assisT in respiratory failure
Randomized, allocation concealed, controlled, open, phase 3 pragmatic clinical effectiveness trial to determine whether VV-ECCO2R in mechanically ventilated patients with acute hypoxaemic respiratory failure in intensive care improves mortality at 90 days.
The SOLVE ARDS Study Program
Strategies for Optimal Lung Ventilation in ECMO for ARDS
To assess if a CPAP strategy that minimizes end-tidal pulmonary stress/strain mitigates VILI in comparison to current MV using tidal ventilation in severe ARDS patients on VV ECMO
The SUPERNOVA Trial
A Strategy of UltraProtective lung ventilation With Extracorporeal CO2 Removal for New-Onset moderate to seVere ARDS
SUPERNOVA is an ESICM-sponsored trial which has been endorsed by the International ECMO Network. This study will assess changes in pH/ PaO2 /PaCO2, Respiratory Rate and device CO2 clearance in the first 24 hours of ECCO2R following VT and plateau pressure reduction in patients with moderate ARDS. Safety variables during treatment will also be analyzed.
Survey of Bedside ECMO Line (Cannula and Circuit) Practices
Survey to gain an understanding of the practical bedside aspects of care undertaken nationally and internationally, and identify any differences that exist. This baseline data will assist in developing future research priorities and support the establishment of best practice standards of care.