Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial

Peek, Giles J.; Mugford, Miranda; Tiruvoipati, Ravindranath; Wilson, Andrew; Allen, Elizabeth; Thalanany, Mariamma M.; Hibbert, Clare L.; Truesdale, Ann; Clemens, Felicity; Cooper, Nicola J.; Firmin, Richard K.; Elbourne, Diana

doi:10.1016/s0140-6736(09)61069-2

Cited by 2,990 publications

(2,525 citation statements)

References 40 publications

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“…5 Similar to some of the above reports, these investigators showed a significantly higher survival without disability in ECMO vs conventional management (63 vs 47%, respectively; relative risk, 0.69; 95% CI, 0.05 to 0.97; P = 0.03). These results, however, were not without several caveats.…”

supporting

confidence: 76%

“…5 Tout comme dans certaines des études citées ci-dessus, les chercheurs de CESAR ont démontré un taux de survie sans handicap significativement plus élevé lors de l'utilisation d'ECMO par rapport à une prise en charge traditionnelle (63 vs 47 %, respectivement; risque relatif, 0,69; IC 95 %, 0,05 à 0,97; P = 0,03). Avec ces résultats viennent toutefois plusieurs mises en garde.…”

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Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

Steinberg

Goldenberg

Laffey

2015

Can J Anesth/J Can Anesth

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supporting

confidence: 76%

unclassified

Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

Steinberg

Goldenberg

Laffey

2015

Can J Anesth/J Can Anesth

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“…Unfortunately, available data come from case series [1-5, 18, 52] and only one randomized clinical trial tested the efficacy of ECMO in patients with severe ARDS [53]. Table 4 presents the main ECMO criteria of these studies together with the ECMO criteria proposed by the Extracorporeal Life Support Organization guidelines [15][16][17][18][19][20] 20±0 17 [15][16][17][18][19][20] 12 [11][12][13][14] 15 [13][14][15][16][17][18][19][20] n. …”

mentioning

confidence: 99%

ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure

et al. 2012

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This is an author version of the contribution published on:Questa è la versione dell'autore dell'opera: [Intensive Care Medicine,38(3),2012, doi: 10.1007/s00134-012-2490 The definitive version is available at: La versione definitiva è disponibile alla URL: [http://download.springer.com/static/pdf/687/art%253A10.1007%252Fs00 134-012-2490 Conclusions:Abnormalities of chest wall mechanics may be present in some patients with influenza A (H1N1)-associated ARDS. These abnormalities may not be inferred from measurements of end-inspiratory plateau pressure of the respiratory system 1 (PPLAT RS ). In these patients, titrating PEEP on PPLAT RS may overestimate the incidence of hypoxemia refractory to conventional ventilation leading to un-appropriate use of ECMO.

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“…The conventional ventilation versus ECMO for severe adult respiratory failure (CESAR) trial first reported a significant improvement in 6 months disability‐free survival in the ECMO group, when compared to conventional ventilation patients 5. Since then, several studies have shown the effectiveness of ECMO for influenza A (H1N1)‐related severe acute respiratory failure in 2009–2010 6, 7.…”

Section: Introductionmentioning

confidence: 99%

Respiratory extracorporeal membrane oxygenation for severe sepsis and septic shock in adults: a propensity score analysis in a multicenter retrospective observational study

Takauji

Hayakawa

Ono

et al. 2017

Acute Medicine & Surgery

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AimThis multicenter retrospective observational study aimed to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) support for septic patients with severe respiratory failure using propensity score analyses.MethodsThe data of severe sepsis patients from 42 intensive care units between January 2011 and December 2013 were retrospectively collected. Propensity score matching analyses were undertaken for severe respiratory failure patients with/without veno‐venous ECMO support. The main outcome was in‐hospital all‐cause mortality.ResultsOf 3195 patients with severe sepsis, 570 had severe respiratory failure. Forty patients in the ECMO group were matched with 150 patients in the control group. A survival time analysis revealed no difference in the in‐hospital survival (hazard ratio, 0.854; 95% confidence interval, 0.531–1.373; P = 0.515). Two‐hundred and eighty‐five patients had severe respiratory failure induced by lung infection. Twenty‐five ECMO group patients were matched with 89 patients in the control group. In the ECMO group, the survival time was longer than in the control group (hazard ratio, 0.498; 95% confidence interval, 0.279–0.889; P = 0.018). The number of renal replacement therapy‐ and vasopressor‐free days improved. The ECMO group received more red blood cells transfused than the control group, but there was no significant difference in the rate of severe bleeding complications between the groups.ConclusionsThere was no difference in the in‐hospital survival between the ECMO group and control group among overall septic patients with severe respiratory failure. However, in sepsis patients with severe respiratory failure induced by lung infection, ECMO support may improve their survival time.

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Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial

Cited by 2,990 publications

References 40 publications

Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

ECMO criteria for influenza A (H1N1)-associated ARDS: role of transpulmonary pressure

Respiratory extracorporeal membrane oxygenation for severe sepsis and septic shock in adults: a propensity score analysis in a multicenter retrospective observational study

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