ARDS and ECMO, an update on critical care nursing

Abstract

The acute respiratory distress syndrome (ARDS) is a very serious pathology caused by inflammation of the lung, usually infectious or traumatic. The alveoli are filled with inflammatory fluid, impairing gas exchange. Mechanical ventilation is the inevitable treatment, but it must ensure specific levels of alveolar pressure, tidal volume, and positive end-expiratory pressure (PEEP) not to exacerbate inflammation and ARDS. This is called protective ventilation but it does not always guarantee satisfactory blood gases, only the extra-corporeal membrane oxygenation (ECMO) can provide. Management of ARDS patient under ECMO is complex because it combines the care related to intensive care patient, very restrictive mechanical ventilation and ECMO. Intensive care nurse requires a very good knowledge of lung disease and respiratory assistance constraints, whether ventilatory or extra-corporeal.