Clinical analysis of extracorporeal membrane oxygenation in treatment of critical patients: A report of 18 cases
10.16781/j.0258-879x.2018.01.0105
- Author:
Fan YANG
1
Author Information
1. Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Critical patient;
Extracorporeal membrane oxygenation;
Indication;
Survival rate;
Thoracic and cardiovascular surgery
- From:
Academic Journal of Second Military Medical University
2018;39(1):105-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the recent clinical results and experience of extracorporeal membrane oxygenation (ECMO) in treating critical patients, so as to summarize the methods, timing and indications of ECMO treatment. Methods We retrospectively analyzed the clinical data (primary disease, supportive mode, adjuvant time and so on) of 18 critical patients treated with ECMO from Jan. 2014 to Nov. 2016 in our hospital, compared the offline rate and success rate of different kinds of critical patients, and analyzed the survival factors and causes of death of the patients. Results Among the 18 critical patients, 12 cases were treated with vein-artery ECMO, four with vein-vein ECMO and two with vein-artery-artery ECMO. Totally seven (38.9%) cases were successfully offline and five (27.8%) cases survived. The offline rate and success rate of the patients with circulatory failure were 62.5% (5/8) and 37.5% (3/8), respectively, while those of the patients with respiratory failure were both 20% (2/10). None of the six patients with adult respiratory distress syndrome (ARDS) secondary to severe burn, trauma or operation survived. The survival rates of patients with ARDS secondary to pulmonary disease (HR=12.3, 95%CI: 2.2-69.9; P0.01) and pat i ent s wi th circulatory failure (HR=4.6, 95% CI: 1.1-19.5; P0.05) were significantly higher than that of patients with ARDS secondary to non-pulmonary causes, while there was no significant difference in survival rate between the patients with circulatory failure and ARDS secondary to pulmonary disease. Conclusion Prompt selection of ECMO treatment time, improvement of the treatment procedure, active treatment of primary disease, and prevention of complications are the keys of ECMO treatment. The establishment of hospital emergency channel and the formation of ECMO treatment team with multidisciplinary and multisectoral cooperation should be carried out to insure the success of ECMO treatment.