학술논문
Chest CT findings in severe acute respiratory distress syndrome requiring V-V ECMO: J-CARVE registry
Document Type
article
Author
Mitsuaki Nishikimi; Shinichiro Ohshimo; Wataru Fukumoto; Jun Hamaguchi; Kazuki Matsumura; Kenji Fujizuka; Yoshihiro Hagiwara; Ryuichi Nakayama; Naofumi Bunya; Junichi Maruyama; Toshikazu Abe; Tatsuhiko Anzai; Yoshitaka Ogata; Hiromichi Naito; Yu Amemiya; Tokuji Ikeda; Masayuki Yagi; Yutaro Furukawa; Hayato Taniguchi; Tsukasa Yagi; Ken Katsuta; Daisuke Konno; Ginga Suzuki; Yuki Kawasaki; Noriyuki Hattori; Tomoyuki Nakamura; Natsuki Kondo; Hitoshi Kikuchi; Shinichi Kai; Saaya Ichiyama; Kazuo Awai; Kunihiko Takahashi; Nobuaki Shime; J-CARVE registry group
Source
Journal of Intensive Care, Vol 12, Iss 1, Pp 1-10 (2024)
Subject
Language
English
ISSN
2052-0492
Abstract
Abstract Background Chest computed tomography findings are helpful for understanding the pathophysiology of severe acute respiratory distress syndrome (ARDS). However, there is no large, multicenter, chest computed tomography registry for patients requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO). The aim of this study was to describe chest computed tomography findings at V-V ECMO initiation and to evaluate the association between the findings and outcomes in severe ARDS. Methods This multicenter, retrospective cohort study enrolled patients with severe ARDS on V-V ECMO, who were admitted to the intensive care units of 24 hospitals in Japan between January 1, 2012, and December 31, 2022. Results The primary outcome was 90-day in-hospital mortality. The secondary outcomes were the successful liberation from V-V ECMO and the values of static lung compliance. Among the 697 registry patients, of the 582 patients who underwent chest computed tomography at V-V ECMO initiation, 394 survived and 188 died. Multivariate Cox regression showed that traction bronchiectasis and subcutaneous emphysema increased the risk of 90-day in-hospital mortality (hazard ratio [95% confidence interval] 1.77 [1.19–2.63], p = 0.005 and 1.97 [1.02–3.79], p = 0.044, respectively). The presence of traction bronchiectasis was also associated with decreased successful liberation from V-V ECMO (odds ratio: 0.27 [0.14–0.52], p