Trial of Venovenous ECMO to De-Sedate, Extubate and Mobilise in Hypoxic Respiratory Failure
This trial tests whether adding a special heart-lung machine (venovenous ECMO) to a breathing machine helps patients with severe lung failure recover faster and spend less time in the intensive care unit. The study compares patients who receive both treatments to those who receive only the breathing machine.
Key Objective: The trial is testing whether adding ECMO support allows doctors to reduce sedation and remove breathing tubes sooner, helping patients recover independence more quickly.
Who to Consider: Patients with moderate to severe acute hypoxic respiratory failure who require mechanical ventilation should consider enrolling in this trial.
Trial Parameters
Brief Summary
To determine whether a strategy of adding venovenous ECMO to mechanical ventilation, as compared to mechanical ventilation alone, increases the number of intensive care free days at day 60, in patients with moderate to severe acute hypoxic respiratory failure.
Eligibility Criteria
Inclusion Criteria: 1. Patients ≥18 to 65 years old 2. Acute hypoxemic respiratory failure characterised by new or worsening respiratory symptoms developing within 2 weeks prior to the onset of need for oxygen or respiratory support 3. Mechanical ventilation of \<7 days 4. Moderate to severe respiratory failure, as demonstrated by two P:F ratios \<150mmHg at least 6 hours apart. Arterial Blood Gases (ABG) with P:F ratio \> 150mmHg are permitted between the two trial inclusion ABGs. 5. Trial of proning (unless contraindicated) Exclusion Criteria: 1. The patient will be extubated today or tomorrow (i.e. will not remain intubated and ventilated the day after tomorrow) 2. Cardiogenic cause of respiratory failure 3. Chronic hypercapnic respiratory failure defined as PaCO2 \> 60 mmHg in the outpatient setting 4. Home mechanical ventilation (non-invasive ventilation or via tracheotomy) except for CPAP/BIPAP used solely for sleep disordered breathing 5. Confirmed diffuse alveolar haemorrhage f