Extracorporeal lung assist: more than kicking a dead horse?

U p to now, the history of extracorporeal lung support has been a tale of great expectations and even greater disappointments. In 1972, HILL et al. [1] published the first case report on the use of extracorporeal membrane oxygenation (ECMO) in a young patient who suffered from acute respiratory distress syndrome (ARDS) after trauma. At that time, mortality rates from ARDS were extremely high and thus this report was embraced with great enthusiasm. However, only 2 yrs later reality caught up when the results of a randomised controlled trial using ECMO in ARDS were published showing mortality rates of .90% in both treatment arms [2].