Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome.
10.4266/kjccm.2014.29.4.266
- Author:
Woo Hyun CHO
;
Dong Wan KIM
;
Hye Ju YEO
;
Seong Hoon YOON
;
Seung Eun LEE
;
Doo Soo JEON
;
Yun Seong KIM
;
Bong Soo SON
;
Do Hyung KIM
- Publication Type:Original Article
- Keywords:
aged;
extracorporeal membrane oxygenation;
respiratory distress syndrome, adult
- MeSH:
Acute Kidney Injury;
Aged*;
Extracorporeal Membrane Oxygenation;
Humans;
Intensive Care Units;
Medical Records;
Patients' Rooms;
Respiratory Distress Syndrome, Adult*;
Retrospective Studies;
Shock, Septic;
Ventilator-Induced Lung Injury
- From:Korean Journal of Critical Care Medicine
2014;29(4):266-272
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
