An expanding number of techniques that can provide adequate oxygenation and carbon dioxide elimination in acute respiratory distress syndrome (ARDS) are available for the critical care expert. These include mechanical ventilation with positive end-expiratory pressure (PEEP)1 and newer modifications of the ventilator's pressure waveforms.2 In addition, extracorporeal life support (ECLS) using a membrane oxygenator can nearly match the success rate achieved by mechanical ventilation using inverse ratio mechanical ventilation and PEEP in ARDS. These observations were obtained in a randomized controlled clinical trial3; the survival rate was 35% to 40% in ARDS patients who, by previous entry criteria, had only a 10% salvage rate.4
See also p 383.
A new innovation in supportive care, partial liquid ventilation using a perfluorocarbon (PFC) instilled directly into the trachea until airways and alveolar units were partially "flooded," appears to be another alternative that can be applied if any one
Petty TL. Innovative Life Support in the Acute Respiratory Distress Syndrome. JAMA. 1996;275(5):404-405. doi:10.1001/jama.1996.03530290074042