Six-Month Outcome of Immunocompromised Patients with Severe Acute Respiratory Distress Syndrome Rescued by Extracorporeal Membrane Oxygenation: An International Multicenter Retrospective Study

Concurrently, successful extracorporeal membrane oxygenation (ECMO) support of the most severe acute respiratory distress syndrome (ARDS) cases, as shown for the recent influenza AC^N^ pandemic or, in the randomized CESAR (Conventional Ventilatory Support versus Extracorporeal Membrane Oxygenation for Severe Adult Respiratory Failure) trial (6-9), led to a steep increase of the number of venovenous (VV)-ECMO procedures performed over the past decade (10, 11). [...]the reported encouraging rates for hospital and longterm survival of immunocompromised patients in ICUs (4) mean that those patients are more likely to receive invasive therapies, like ECMO. [...]the poor prognoses of critically ill patients with solid cancers were previously emphasized, with probabilities of attaining 12 and 18 months of quality-adjusted survival after an ICU stay reported for only 30% and 19%, respectively (32). [...]maintenance of optimal antitumor treatment might often be jeopardized in these patients with severely impaired functional status or residual organ dysfunctions after ECMO weaning. [...]hospital survival was 55% in 2,584 AIDS patients on mechanical ventilation for various reasons, with mechanical ventilation during an ICU stay being strongly associated with mortality according to multivariate analysis (OR, 3.5 [95% CI, 2.9-4.2]) (3). [...]although all participating centers applied ultraprotective ventilation in ECMO patients, we did not report daily detailed mechanical-ventilation settings, which has been highlighted as an important determinant of the outcome of patients on ECMO for respiratory failure (37, 45).