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This is a report of 76 patients with severe ARDS who were treated by ECCO2-R. Twenty-six of these 76 patients required thoracotomy: 19 for pneumothorax and pneumatocele, and seven for haemothorax, infected lung necrosis or oesophagotracheal fistula. Most pneumothoraces were bilateral. Ten of these 26 patients required reoperation, usually for extensive persisting alveolar air leaks. Sixteen (62 per cent) of the 26 patients who had a thoracotomy and 22 (44 per cent) of the 50 patients without surgery survived. These results demonstrate that performing a thoracotomy, if necessary, does not diminish the survival chance of high-risk patients with severe ARDS.<\/jats:p>","DOI":"10.1002\/bjs.1800771224","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T13:52:09Z","timestamp":1172929929000},"page":"1395-1398","source":"Crossref","is-referenced-by-count":26,"title":["Extracorporeal gas exchange in adult respiratory distress syndrome: Associated morbidity and its surgical treatment"],"prefix":"10.1093","volume":"77","author":[{"given":"P K","family":"Wagner","sequence":"first","affiliation":[{"name":"Department of Surgery, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Knoch","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Therapy, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Sangmeister","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Therapy, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Lennartz","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Therapy, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Rothmund","sequence":"additional","affiliation":[{"name":"Department of Surgery, Philipps University Hospital , Marburg, FRG"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1990,12,1]]},"reference":[{"key":"2024092808065143400_bib1","first-page":"472","article-title":"Adult respiratory distress syndrome prognosis after onset","volume":"132","author":"Fowler","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"2024092808065143400_bib2","first-page":"479","article-title":"Pulmonary extraction of serotonin and propranolol in patients with adult respiratory distress syndrome","volume":"132","author":"Morel","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"2024092808065143400_bib3","first-page":"1","volume-title":"Acute Respiratory Failure","author":"Pontoppidan","year":"1985"},{"key":"2024092808065143400_bib4","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1001\/jama.1979.03300200023016","article-title":"Extracorporeal membrane oxygenation in severe acute respiratory failure","volume":"242","author":"Zapol","year":"1979","journal-title":"JAMA"},{"key":"2024092808065143400_bib5","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/S0140-6736(80)90237-8","article-title":"Treatment of acute respiratory failure with low frequency positive pressure ventilation and extracorporeal removal of CO2","volume":"ii","author":"Gattinoni","year":"1980","journal-title":"Lancet"},{"key":"2024092808065143400_bib6","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1055\/s-2008-1066676","article-title":"Extracorporale CO2-elimination","volume":"114","author":"Knoch","year":"1989","journal-title":"Dtsch med Wschr"},{"key":"2024092808065143400_bib7","first-page":"312","article-title":"Severe impairment in lung function induced by high peak airway pressure during mechanical ventilation","volume":"135","author":"Kolobow","year":"1985","journal-title":"Am Rev Respir Dis"},{"key":"2024092808065143400_bib8","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2214\/ajr.129.2.209","article-title":"PEEP: radiographic features and associated complications","volume":"129","author":"McLoud","year":"1977","journal-title":"Am J Roentgenol"},{"key":"2024092808065143400_bib9","first-page":"360","article-title":"Ventilator-induced, subpleural air cysts: clinical, radiographic and pathologic significance","volume":"127","author":"Albelda","year":"1983","journal-title":"Am Rev Respir Dis"},{"key":"2024092808065143400_bib10","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1378\/chest.67.2.156","article-title":"High level positive end expiratory pressure (PEEP) in acute respiratory insufficiency","volume":"67","author":"Kirby","year":"1975","journal-title":"Chest"},{"key":"2024092808065143400_bib11","first-page":"123","volume-title":"Neonatal and Adult Respiratory Failure. 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