What about prognostic outcome parameters in patients with acute respiratory distress syndrome (ARDS) treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO)?

The acute respiratory distress syndrome (ARDS) remains a clinically relevant disease and causes high morbidity and mortality (1). Various treatment approaches exist to cope with the most critical patient courses. In the last decades therapeutic options for primary or secondary pulmonary failures were enlarged by the increasing spread and use of ECMO. The rate of treatments of severe respiratory failure with veno-venous extracorporeal membrane oxygenation (VV-ECMO) is rapidly increasing counting more than 15,600 adult treatments in the Extracorporeal Life Support Organization Registry in February 2018. In the treatment of ARDS, the VV-ECMO is a meanwhile established therapeutic approach despite ongoing discussion regarding evidence (2). Although there are consented parameters for indication of VV-ECMO (2), we are still lacking suitable prognostic parameters, that give us an arbitration about the potential success of ECMO treatment and about outcome of treated patients.