Extracorporeal Membrane Oxygenation Support in Adult Patients with Hematologic Malignancies and Severe Acute Respiratory Failure.
10.4266/kjccm.2016.00318
- Author:
Tai Sun PARK
;
You Na OH
;
Sang Bum HONG
;
Chae Man LIM
;
Younsuck KOH
;
Je Hwan LEE
;
Jung Hee LEE
;
Kyoo Hyung LEE
;
Jin Won HUH
- Publication Type:Original Article
- Keywords:
hematologic neoplasms;
extracorporeal membrane oxygenation;
respiratory insufficiency
- MeSH:
Adult*;
APACHE;
Critical Illness;
Extracorporeal Membrane Oxygenation*;
Hematologic Neoplasms*;
Hemorrhage;
Humans;
Intensive Care Units;
Intracranial Hemorrhages;
Lung Injury;
Male;
Medical Records;
Respiratory Distress Syndrome, Adult;
Respiratory Insufficiency*;
Retrospective Studies;
Tertiary Care Centers;
Weaning
- From:Korean Journal of Critical Care Medicine
2016;31(3):243-250
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO. METHODS: We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015. RESULTS: A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56). CONCLUSIONS: Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.
