id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-034141-3uty6rwi	Joyce, David L.	Mechanical ventilation: A necessary evil?	2020-10-22		.txt	text/plain	552	36	41	1 Although recent clinical trials have failed to establish the superiority of mechanical circulatory support over mechanical ventilation in these patients, 2 extracorporeal membrane oxygenation (ECMO) has traditionally been reserved for refractory cases and most often performed through femoral cannulation. 3 Recognizing that acute respiratory distress syndrome in the context of COVID-19 frequently leads to increasing pressor requirements and progression to multiple organ dysfunction syndrome, we hypothesized that early intervention with a percutaneous right ventricular assist device/ECMO approach might improve outcomes in these patients. Pressor requirements have been eliminated with this approach, and our practice has been to extubate while on ECMO support to facilitate rehabilitation and avoid ongoing barotrauma. Nevertheless, cardiothoracic surgeons who are asked to cannulate a patient for COVID-19 in the setting of increasing pressor requirements or secondary organ failure should carefully evaluate the potential for right ventricular dysfunction as a contributor.	./cache/cord-034141-3uty6rwi.txt	./txt/cord-034141-3uty6rwi.txt