Abstract
The usefulness of managing adult patients with severe acute respiratory distress syndrome and hypoxemia by means of systems using extracorporeal oxygenation has been questioned. A National Institutes of Health multicentre study, published in 1979, reported survival rates of 9.5% and 8.3% in extracorporeally and ventilator managed patients, respectively. Another recent study reports survival rates of 33% and 42% in ventilator and extracorporealy managed patients, respectively. None of these differences was statistically significant. Indications for extracorporeal oxygenation may need to be re-evaluated to clarify those cases that would not be manageable with current ventilation strategies and, hence, would merit extracorporeal support.