FIGURE 13.

Chest X-rays (CXRs) and blood gases in a patient with respiratory failure on extracorporeal membrane oxygenation (ECMO). (A) CXR and blood gases (arterial pH, PCO₂, and PO₂ with the calculated PaO₂/FiO₂ ratio) at 15 days on ECMO and protective ARDSnet pressure-control assist-control ventilation (PC-AC). Bilateral infiltrates can be seen throughout the lung with a PaO₂/FiO₂ ratio of 196. (B) After 30 days on ECMO and PC-AC, the patient showed some clearing in the upper right quadrant but a worsening PaO₂/FiO₂ ratio of 75. (C) Two days after conversion to the TCAV method, the patient showed marked improvement in CXR and PaO₂/FiO₂ ratio (275). (D) After 11 days on the TCAV method, the patient showed a cleared CXR and normalized PaO₂/FiO₂ ratio (414). The patient came off of ECMO and was extubated. Written informed consent obtained for the use of these images.