Patients with acute respiratory distress syndrome (ARDS) receiving mechanical ventilation have a high risk of barotrauma, which often has poor prognosis and high mortality. Although ECMO should theoretically protect patients from barotrauma, whether it does is unclear.

Investigators in China therefore sought to assess the incidence, risk factors, and epidemiology of barotrauma in patients with ARDS treated with ECMO.

The researchers conducted a retrospective analysis of 127 patients at least 15 years of age with ARDS treated with veno-venous ECMO at the China-Japan Friendship Hospital, Beijing, China, from December 2013 to December 2021.

Patients with COVID-19 were excluded. Of those patients 21 had barotrauma before ECMO, 24 (18.9%) developed barotrauma during ECMO, and 9 (7.1%) patients developed barotrauma after ECMO.

Among the 24 patients who developed barotrauma during ECMO (median age, 38 years, 37.5% women) median total ECMO run time was 29 days and median length of hospital stay was 43 days.

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