• Surat Tongyoo, Chairat Permpikul, Siwalai Sucher, Preecha Thomrongpairoj, Akekarin Poompichet, Ranistha Ratanarat, and Nitipatana Chierakul.
• Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
• J. Int. Med. Res. 2020 Jun 1; 48 (6): 300060520935704.

ObjectiveTo compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010.MethodsThis retrospective cohort study enrolled adults with severe ARDS (PaO2/FiO2 ratio of <100 with FiO2 of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. The primary outcome was hospital mortality.ResultsSixty-four patients (ECMO, n = 30; mechanical ventilation, n = 34) were recruited. There was no significant difference in the baseline PaO2/FiO2 ratio (67.2 ± 25.7 vs. 76.6 ± 16.0), FiO2 (97 ± 9 vs. 94 ± 8), or Murray score (3.4 ± 0.5 vs. 3.3 ± 0.5) between the ECMO and mechanical ventilation groups. The hospital mortality rate was also not significantly different between the two groups (ECMO, 20/30 [66.7%] vs. mechanical ventilation, 24/34 [70.6%]). Patients who underwent ECMO were ventilated with a significantly lower TV than patients who underwent mechanical ventilation (3.8 ± 1.8 vs. 6.6 ± 1.4 mL, respectively).ConclusionAlthough VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT04031794).

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