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Better Outcomes With Extra-Corporeal Membrane Oxygenation Than With Conventional Ventilation in Severe But Potentially Reversible Respiratory Failure: Presented at CCCF By Pam Harrison TORONTO, CANADA -- November 5, 2007 -- Extra-corporeal membrane oxygenation (ECMO) produces significantly superior outcomes after 6 months of follow-up than conventional ventilation in adults with severe but potentially reversible respiratory failure, according to results from the Conventional ventilation or ECMO for Severe Adult Respiratory failure (CESAR) study. Giles Peek, MD, Lecturer, Department of Cardiac Surgery, University of Leicester, Leicester, United Kingdom, and colleagues enrolled 180 adults with severe but potentially reversible respiratory failure. Dr. Peek presented the findings here at the Critical Care Canada Forum (CCCF). The researchers randomised 87 of these patients to conventional treatment with intermittent positive pressure ventilation and 68 patients to treatment with ECMO. For the purposes of the CESAR protocol, conventional ventilation was defined as any treatment that relied on the patient's lungs to provide gas exchange. ECMO, in contrast, uses cardiopulmonary bypass technology to temporarily provide gas exchange, which allows the lungs to recover. The mean age of the cohort was approximately 40 years, and slightly over half of each group had pneumonia at study entry. The primary endpoint was death or severe disability at 6 months. Results show that 63% of patients randomised to the ECMO arm had not reached the primary outcome of death or severe disability at 6 months versus 43% of those in the conventional arm, a difference that was significant (P =.03), Dr. Peek reported. "The benefit of ECMO was seen regardless of age or the number of organs involved," he added, "and for every 6 patients treated with ECMO, there is one extra survivor." [Presentation title: The CeSar Trial -- Results From the UK ECMO Trial.] E-mail this page to a friend or colleague! To print, use this version