High survival rate in 122 ARDS patients managed according to a clinical algorithm including extracorporeal membrane oxygenation

@article{Lewandowski1997HighSR,
  title={High survival rate in 122 ARDS patients managed according to a clinical algorithm including extracorporeal membrane oxygenation},
  author={K. Lewandowski and Rolf Rossaint and Dirk Pappert and Herwig Gerlach and K J Slama and H. Weidemann and D. J. M. Frey and Olaf Hoffmann and U. Keske and Konrad J. Falke},
  journal={Intensive Care Medicine},
  year={1997},
  volume={23},
  pages={819-835}
}
Abstract Objective: We investigated whether a treatment according to a clinical algorithm could improve the low survival rates in acute respiratory distress syndrome (ARDS). Design: Uncontrolled prospective trial. Setting: One university hospital intensive care department. Patients and participants: 122 patients with ARDS, consecutively admitted to the ICU. Interventions: ARDS was treated according to a criteria-defined clinical algorithm. The algorithm distinguished two main treatment groups… 
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281 Citations
Highly Influential Citations
13
Background Citations
48
Methods Citations
20
Results Citations
5

281 Citations

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TLDR
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References

SHOWING 1-10 OF 121 REFERENCES
Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. An international, multicenter, prospective survey.
An international, multicenter, prospective survey has been conducted to determine the hospital survival rates of patients with potentially reversible acute respiratory failure (ARF) who are managed…
Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome.
TLDR
It is concluded that there was no significant difference in survival between the mechanical ventilation and the extracorporeal CO2 removal groups, and extracordoreal support for ARDS should be restricted to controlled clinical trials.
Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study.
TLDR
It is concluded that ECMO can support respiratory gas exchange but did not increase the probability of long-term survival in patients with severe ARF.
Progress in Veno-Venous Long-Term Bypass Techniques for the Treatment of Ards
TLDR
The disadvantage of the hollow fiber oxygenators in the heparin-coated system was plasma leakage, which was more frequent in patients with pancreatitis and hyperbilirubinemia.
A prospective study of lung water measurements during patient management in an intensive care unit.
TLDR
It is concluded that management based on a protocol using EVLW measurements is safe, may hasten the resolution of pulmonary edema, and may lead to improved outcome in some critically ill patients.
Causes of Mortality in Patients with the Adult Respiratory Distress Syndrome
TLDR
It is indicated that sepsis syndrome, rather than respiratory failure, is the leading cause of death in patients with ARDS.
Treatment of adult respiratory distress syndrome with diuretics, dialysis, and positive end‐expiratory pressure
  • R. Bone
  • Medicine
    Critical care medicine
  • 1978
TLDR
A new treatment protocol has been proposed that uses high positive end-expiratory pressure early in the course of adult respiratory distress syndrome; mortality using this technique was 20% and the difference in survival may be more apparent than real.
Frequency and importance of barotrauma in 100 patients with acute lung injury.
TLDR
It is hypothesized that barotrauma is an indication of severity of acute lung injury rather than a major cause of increased mortality, and was an independent marker of mortality when adjusted for other predictors of mortality.
Extracorporeal life support for adult cardiorespiratory failure.
TLDR
With modern techniques, ECLS can be lifesaving in adult cardiorespiratory failure when conventional therapy has failed, and this new phase 1 trial of modern extracorporeal life support in moribund adults with cardiorespiratory failure shows this.
Hepatic dysfunction in the adult respiratory distress syndrome.
Multiple organ system failure is a major cause of mortality in the adult respiratory distress syndrome (ARDS). We serially evaluated parameters of multiple organ function in 24 patients during the…
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