Extracorporeal membrane oxygenation for adult patients with acute poisoning in China: a retrospective analysis of CSECLS registry from 2017 to 2021
10.3760/cma.j.issn.1671-0282.2022.12.004
- VernacularTitle:体外膜肺氧合在中国急性中毒成人患者中的应用：2017-2021年体外生命支持登记的回顾性分析
- Author:
Meng XIN
1
;
Haixiu XIE
;
Zhongtao DU
;
Xiaojun LIU
;
Huanzhang SHAO
;
Hong WANG
;
Xing HAO
;
Chenglong LI
;
Liangshan WANG
;
Xiaotong HOU
Author Information
1. 首都医科大学附属北京安贞医院心脏外科危重症中心，北京 100029
- Keywords:
ECMO;
Poisoning;
Respiratory failure;
Circulatory failure;
Pesticide;
Extracorporeal Life Support
- From:
Chinese Journal of Emergency Medicine
2022;31(12):1597-1602
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the status of extracorporeal membrane oxygenation (ECMO) for poisoned patients in China, and prognosis, complications and risk factors for death in poisoned patients supported with ECMO.Methods:The data of adult poisoned patients registered in Chinese Society of Extracorporeal Life Support (CSECLS) database were collected. Patients were divided into the survival group and death group according to the conditions at discharge. The type of poisoning, patient prognosis, hemodynamic parameters and complications before and after ECMO were retrospectively analyzed.Results:A total of 96 poisoned patients supported with ECMO were included in the database from 2017 to 2022, including 77 adult patients. The use of ECMO for poisoning was more common in Henan Province (28 cases, 36%), Guangdong Province (11 cases, 14%) and Zhejiang Province (9 cases, 8%). The number of adult poisoned patients registered in the database increased over time from 2017 to 2022, but the survival rate showed no significant difference ( P = 0.794). Agricultural poisoning was the most common indication (43%). Veno-arterial (V-A) ECMO was used in 60 patients (78%) and venovenous (V-V) ECMO in 27 patients (22%). Thirty-two patients (42%) survived to hospital discharge. The mean duration of ECMO support was 57 (34, 123) h, the mean duration of mechanical ventilation was 88 (33, 211) h, the mean length of hospital stay was 10 (2, 21) days, and the mean length of ICU stay was 9 (2, 18) days. Multivariate analysis showed that 24-h lactic acid level was significantly associated with mortality ( OR = 0.378, 95% CI: 0.183-0.779, P = 0.008). Conclusions:ECMO can be used as a salvage strategy to treat various types of severe poisoning. Although the application of ECMO is expanded rapidly in China, it is still necessary to optimize intervention indications and treatment timing, and adopt standardized ECMO management and monitoring strategies to improve the prognosis of patients.
