ReviewCritical care (London, England)2016
"Awake" extracorporeal membrane oxygenation (ECMO): pathophysiology, technical considerations, and clinical pioneering.
Review in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 2 syntheses or guidelines pooled it, 214 citations in OpenAlex.
- Pooled it
- Awake extracorporeal life support and physiotherapy in adult patients: A systematic review of the literature.Perfusion · 2023Pooled it
- Strategies for lung- and diaphragm-protective ventilation in acute hypoxemic respiratory failure: a physiological trial.Critical care (London, England) · 2022Trial
- Feasibility and safety of awake extracorporeal membrane oxygenation for operating room extubation after lung transplantation.Journal of thoracic disease · 2026Article
- Awake VV-ECMO for severe pneumonia caused by Elizabethkingia anophelis: a case report.BMC infectious diseases · 2026Article
- Reflections on Consciousness in Intensive Care.Acta paediatrica (Oslo, Norway : 1992) · 2026Review
- Awake vs. Sedated Cannulation for Extra-Corporeal Membrane Oxygenation in Patients with COVID-19 Induced Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2026Article
- Extracorporeal life support for adult patients with ARDS.Intensive care medicine · 2025Review
- Sedation management and processed EEG-based solutions during venovenous extracorporeal membrane oxygenation: a narrative review of key challenges and potential benefits.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Application of a novel extracorporeal membrane oxygenation system in awake Hu sheep under various durations.BMC anesthesiology · 2025Article
- Extracorporeal membrane oxygenation for prevention of barotrauma in patients with respiratory failure: A scoping review.Artificial organs · 2025Article
- Case Report: Rescue "awake" extracorporeal membrane oxygenation for acute respiratory failure in severe granulomatosis with polyangiitis with multisystem involvement.Frontiers in medicine · 2025Article
- Local Anesthetic Infiltration, Awake Veno-Venous Extracorporeal Membrane Oxygenation, and Airway Management for Resection of a Giant Mediastinal Cyst: A Narrative Review and Case Report.Journal of clinical medicine · 2024Review
- ECMO for bridging lung transplantation.European journal of medical research · 2024Review
- Extracorporeal membrane oxygenation in cardiovascular medication poisoning. A German-wide retrospective study.Scientific reports · 2024Article
- Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome.Journal of clinical medicine · 2024Article
- Alternative venous access sites for dual-lumen extracorporeal membrane oxygenation cannulation.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) Support in New Era of Heart Transplant.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- Awake venovenous extracorporeal membrane oxygenation and survival.Frontiers in medicine · 2024Article
- Standardized approach for extubation during extracorporeal membrane oxygenation in severe acute respiratory distress syndrome: a prospective observational study.Annals of intensive care · 2023Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the timing of ECMO initiation has been readdressed and ECMO is often started earlier in the time course of respiratory failure. Furthermore, some centers are starting to use ECMO as a first line of treatment, i.e., as an alternative to invasive mechanical ventilation in awake, non-intubated, spontaneously breathing patients with respiratory failure ("awake" ECMO). There is a strong rationale for this type of respiratory support as it avoids several side effects related to sedation, intubation, and mechanical ventilation. However, the complexity of the patient-ECMO interactions, the difficulties related to respiratory monitoring, and the management of an awake patient on extracorporeal support together pose a major challenge for the intensive care unit staff. Here, we review the use of vv-ECMO in awake, spontaneously breathing patients with respiratory failure, highlighting the pros and cons of this approach, analyzing the pathophysiology of patient-ECMO interactions, detailing some of the technical aspects, and summarizing the initial clinical experience gained over the past years.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.