Refractory ARDS ECMO — FRCA Final MCQ

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HardIntensive Care MedicineRefractory ARDS ECMOFRCA Final

Severe ARDS (P/F <100) refractory to lung-protective ventilation, prone, and NMB. Next escalation?

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Correct answer: E — ECMO referral

EOLIA trial: VV-ECMO for severe refractory ARDS. Refer early. iNO improves oxygenation transiently but no mortality benefit. HFOV showed harm (OSCILLATE). ECMO is the appropriate escalation for refractory hypoxaemia.

Reference: ICS/BTS – 2023 – ARDS guidelines; ELSO – 2024