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Literature Summary

Major Literature

  1. Peek. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009; 374: 1351-63  (abstract)
    • In a multicenter, randomized control trial, comparing ongoing conventional mechanical ventilation in a non-ECMO centre with transfer to an ECMO centre for respiratory support with either conventional mechanical ventilation or ECMO in 180 patients with severe hypoxic respiratory failure, ECMO centre management, where only 75% of the transferred patients actually received ECMO, was associated with increased 6-month survival (63% vs. 47%, relative risk 0.69, 95% CI 0.05 to 0.97, P=0.03) and a gain of 0·03 quality-adjusted life-years at 6-months, with a lifetime model predicting the cost per QALY of ECMO to be £19 252 (95% CI 7622—59 200) at a discount rate of 3·5%