in the setting of怎么理解？谢谢

The results of the initial randomized control trials for ECMO for ARDS did not support the use of ECMO for severe ARDS.In 2009, the Conventional ventilation or ECMO for Severe Adult Respiratory failure (CEASAR) trial was conducted in the UK to reevaluate the use of ECMO for ARDS in the setting of modern ventilation strategies and improved patient selection.In this multicenter, randomized, controlled trial, 180 patients were enrolled and assigned randomly to either conventional management or consideration for venovenous (VV)-ECMO. Of the 90 patients randomized to the ECMO arm of the trial, 85 were successfully transferred to a center with ECMO capability and 75% ultimately underwent VV-ECMO cannulation. The primary end point of survival to 6 months after randomization was achieved by 63% of patients within the ECMO consideration group and 47% patients within conventional management group.

ECMO治疗ARDS的初步随机对照试验结果不支持ECMO用于严重ARDS。2009年，在现代通气策略和改善患者选择的情况下，英国进行了常规通气或ECMO治疗重症成人呼吸衰竭(CEASAR)研究，重新评价ECMO治疗ARDS的应用。(2009年，在英国进行了常规通气或ECMO治疗严重成人呼吸衰竭(CEAAR)研究，以重新评估ECMO治疗ARDS在制定现代通气策略和改善患者选择方面的使用情况。)

在这项多中心、随机、对照研究中，180例患者被纳入并随机分配到常规治疗组或考虑静脉(VV)-ECMO组。随机分配到试验ECMO组的90例患者中，85例成功转移到具有ECMO能力的中心，75%最终接受VV-ECMO治疗。ECMO考虑组63%的患者和常规治疗组47%的患者达到了随机化后6个月生存的主要终点。