Extracorporeal life support for patients with acute respiratory distress syndrome (Adult and Paediatric). Consensus conference organized by the French Intensive Care Society

Abstract

The H1N1 influenza epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients with severe acute respiratory distress syndrome, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain. Organized by the Société de réanimation de langue française (SRLF) in conjunction with the Société française d’anesthésie et de réanimation (Sfar), the Société de pneumologie de langue française (SPLF), the Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP), the Société française de perfusion (Sofraperf), the Société française de chirurgie thoracique et cardiovasculaire (SFCTV) et the Société espagnole de soins intensifs (SEMICYUC), a consensus conference was held in December 2013 and a jury of 13 members wrote 65 recommendations to answer the five following questions regarding the place of extracorporeal life support for patients with acute respiratory distress syndrome: 1) What are the available techniques? 2) Which patients could benefit from extracorporeal life support? 3) How to perform extracorporeal life support? 4) How and when to stop extracorporeal life support? 5) Which organization should be recommended? To write the recommendations, evidence-base medicine (GRADE method), expert panel opinions, and shared decisions taken by all the thirteen members of the jury of the consensus conference were taken into account.