학술논문

Hospital survival outcomes in acute respiratory distress syndrome patients receiving veno‐venous extracorporeal membrane oxygenation for longer than 28 days: A retrospective study.
Document Type
Article
Source
Artificial Organs. Dec2021, Vol. 45 Issue 12, p1533-1542. 10p.
Subject
*ADULT respiratory distress syndrome
*SURVIVAL rate
*EXTRACORPOREAL membrane oxygenation
*POSITIVE end-expiratory pressure
Language
ISSN
0160-564X
Abstract
The successful use of prolonged (ie, >28 days) veno‐venous extracorporeal membrane oxygenation (V‐V ECMO) is being increasingly reported. However, limited data are available on its outcomes. This study investigated the outcomes of acute respiratory distress syndrome (ARDS) patients on prolonged ECMO support. We retrospectively evaluated 57 patients requiring V‐V ECMO for ARDS between 2015 and 2020. The patients were divided into two groups according to ECMO duration: (a) ≤28 days group (n = 43, 75%) or (b) >28 days (n = 14, 25%) group. Clinical characteristics, complications, and outcomes between these two groups were statistically compared. There were no significant differences in demographics, comorbidity, ARDS etiology, and severity scores between the two groups. However, the mechanical ventilation period before ECMO initiation was significantly longer in the >28 days group than in the ≤28 days group (10.5 days vs. 1 day; P <.05). The incidence of positive bacterial blood culture results during ECMO was significantly higher in the >28 days group than in the ≤28 days group (43% vs. 9%; P <.05). Additionally, the hospital survival rate was significantly lower in the >28 days group than in the ≤28 days ECMO group (21% vs. 60%; P <.05). Prolonged ECMO was associated with worse hospital survival outcomes. Early initiation of ECMO along with meticulous care and appropriate treatment against infection during ECMO could improve the hospital survival of ARDS patients on prolonged ECMO support. [ABSTRACT FROM AUTHOR]