Outcomes of Venovenous Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome in Adults.
10.5090/kjtcs.2012.45.2.91
- Author:
Dae Sung MA
1
;
Joon Bum KIM
;
Sung Ho JUNG
;
Suk Jung CHOO
;
Cheol Hyun CHUNG
;
Jae Won LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea. jbkim1975@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Acute respiratory distress syndrome;
Extracorporeal membrane oxygenation
- MeSH:
Adult;
Extracorporeal Membrane Oxygenation;
Humans;
Inhalation;
Logistic Models;
Nitric Oxide;
Renal Replacement Therapy;
Respiratory Distress Syndrome, Adult;
Retrospective Studies;
Shock;
Weaning
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2012;45(2):91-94
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Despite improved managements for acute respiratory distress syndrome (ARDS), its mortality remains high. Extracorporeal membrane oxygenation (ECMO) has emerged as the final option for the treatment of ARDS unresponsive to conventional measures. This study describes our experiences of venovenous ECMO support for the treatment of ARDS. MATERIALS AND METHODS: Between 2007 and 2010, 56 patients (aged 56.6+/-13.4 years, 43 males) received venovenous ECMO for the treatment of ARDS. The detailed clinical records were retrospectively reviewed. RESULTS: Before the institution of ECMO support, 35 patients (55.4%) required nitric oxide inhalation, 35 patients (55.4%) received continuous renal replacement therapy, and 20 patients (35.7%) were in shock status. The median duration of ECMO support was 164 hours (range, 5 to 1,413 hours). 27 (48%) patients could be successfully weaned from ECMO. Of them, 7 (13%) survived to discharge. On logistic regression analysis, a requirement for higher inspiratory pressure before ECMO support was the only significant factor that could predict ECMO weaning failure. CONCLUSION: The outcome of venovenous ECMO support for the treatment of ARDS was suboptimal. Further improvements in outcomes should be made through the accumulation of experience and establishment of a standardized protocol for the management of ECMO.
