At our institution, PLV continues to be used as an investigational therapy for patients with ARDS who meet the protocol criteria. Since this is the beginning of the first nonneonatal clinical trial of PLV, results of this therapy are not yet available. Adverse effects on hemodynamic parameters have not been documented in the current literature for patients treated with liquid ventilation. In addition, further clinical studies using PLV therapy will be necessary to determine whether it will significantly change the morbidity and mortality of ARDS in infants or adults. Other questions to be answered include the cost-effectiveness of using this therapy for patients with ARDS, as well as what type of program will be required to carry out this therapy. It is hoped that this type of ventilatory therapy will offer an effective, simple method of treatment for patients with ARDS in the future.
In recent years, we have experienced advances in treatments for severe ARDS. One that holds promise for these critically ill adult patients is ECMO, which can provide gas exchange and lung rest for the patient in severe reversible respiratory failure. Advances in ECMO techniques, appropriate patient selection and the development of heparinized tubing will all improve the potential for survival in patients who are placed on ECMO therapy in the future.