EOLIA trial: the future of extracorporeal membrane oxygenation in acute respiratory distress syndrome therapy?

Abstract

This was a prospective, multi-centre randomised controlled trial that involved centres in 16 countries. The trial was designed as a group sequential analysis with data analysed after randomisation of every 60 participants; stopping rules were predefined using the two triangle method. The trial could be stopped due to safety (due to excessive mortality in the ECMO arm), efficacy or futility (if unlikely to reach a definitive result). The trial was designed to have a power of 80% and alpha level of 5% to detect an absolute risk reduction of 20%. It was hypothesised that the mortality would be 60% in the conventional arm and 40% in the ECMO arm. Mortality at 60 days was the primary outcome measured.

SARS-Cov2: A Review of this Novel Coronavirus

“…Whilst there has been enthusiasm for corticosteroid use in SARS-CoV2 ARDS, there is little evidence for their prescription, and they are not currently recommended having shown no promise in SARS or MERS previously. At present high-flow nasal oxygen therapy is considered a good highly available intervention that can in patients prevent the need for intubation but requires intense monitoring [21][22][23][24][25]. Given the large numbers of patients affected by SARS-CoV2, massive coordinated action must be undertaken by health agencies to increase both ICU beds and expertise amongst non-ICU trained staff on traditional hospital wards.…”

Gadobutrol-induced acute respiratory distress syndrome rescued by intravenous immunoglobulin and extracorporeal membrane oxygenation

“…IVIG may be bene cial for patients who do not respond to conventional therapies [2]. In cases of critical anaphylaxis and ARDS, early lung-replacement therapy with ECMO has been shown to improve outcomes for patients with ARDS and has been used in selective patients as a rescue therapy to maintain systemic circulation and tissue oxygenation [3].…”

Oxigenación con membrana extracorpórea

“…El estudio EOLIA de 2018, es el estudio más grande con uso de terapia ECMO veno-venoso en el SDRA severo comparando 2 grupos, ambos con SDRA severo, uno se le colocaba el ECMO veno-venoso (específicamente Pa/FiO 2 menor a 50 mmHg por 3 h o Pa/ FiO 2 menor a 80 mmHg por 6 h o pH arterial menor a 7,25 con una presión parcial de PaCO 2 mayor a 60 mmHg por 6 h, siendo la meta primaria la mortalidad a 60 días [38] (Tabla 2).…”