In ARDS, the percentage of potentially recruitable lung is extremely variable and is strongly associated with the response to PEEP.

In ARDS, especially in patients with higher lung recruitability, the beneficial impact of reducing intratidal alveolar opening and closing by increasing PEEP prevails over the effects of increasing alveolar strain.

Prone positioning enhances lung recruitment and decreases alveolar instability and hyperinflation observed at high PEEP in patients with ARDS.

A single session of HVHF as salvage therapy in the setting of a goal-directed hemodynamic management algorithm may be beneficial in severe refractory hyperdynamic septic-shock patients. This approach may improve hemodynamics and perfusion parameters, acid-base status, and ultimately hospital survival. Moreover, it is feasible, and safe.

At a Glance Commentary Scientific Knowledge on the SubjectExtracorporeal membrane oxygenation (ECMO) has been incorporated in the World Health Organization recommendations for the management of COVID-19-associated severe acute respiratory distress syndrome (ARDS). However, the incidence of ECMO use, its time course and outcomes are unknown at a nationwide level under the COVID-19 pandemic scenario. What This Study Adds to the FieldIn this nationwide study, all patients who received ECMO for severe ARDS during the first wave of COVID-19 pandemic in Chile were identified. The incidence and time course of ECMO use was similar to that observed in the 2009 influenza A(H1N1) pandemic in Australia/New Zealand.The mortality rate was comparable to that reported for other indications of extracorporeal respiratory support. The operation of a National Advisory Commission for Adult ECMO was key to assist patient eligibility, transportation and allocation in tertiary centers in a resource-limited and logistically complex pandemic scenario. These findings might be useful for future COVID-19 pandemic waves worldwide. Total word count: 3475Funding: This investigation had no funding or grant.