Venovenous Extracorporeal Membrane Oxygenation for Postoperative Acute Respiratory Distress Syndrome
The Korean Journal of Thoracic and Cardiovascular Surgery
;
: 180-186, 2015.
Artículo
en Inglés
| WPRIM
| ID: wpr-95900
ABSTRACT
BACKGROUND:
Extracorporeal membrane oxygenation (ECMO) has recently attracted interest as a treatment for severe acute respiratory distress syndrome (ARDS). However, the outcomes of this procedure in post-surgical settings have not yet been characterized. In this study, we evaluated the outcomes of ECMO in patients with severe postoperative ARDS.METHODS:
From January 2007 to December 2012, a total of 69 patients (aged 58.3+/-11.5 years, 23 females) who underwent venovenous ECMO to treat severe postoperative ARDS were reviewed. Of these patients, 22 (31.9%) had undergone cardiothoracic surgery, 32 (46.4%) had undergone liver transplantation, and 15 (21.7%) had undergone other procedures.RESULTS:
Thirty-four patients (49.3%) were successfully weaned from ECMO, while the other 35 patients (50.7%) died on ECMO support. Among the 34 patients who were successfully weaned from ECMO, 21 patients (30.4%) eventually died before discharge from the hospital, resulting in 13 hospital survivors (18.8%). Multivariable analysis showed that the duration of pre-ECMO ventilation was a significant independent predictor of death (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.29 to 3.90; p=0.004), whereas the concomitant use of continuous venovenous hemodialysis (CVVHD) was associated with improved survival (OR, 0.55; 95% CI, 0.31 to 0.97; p=0.038).CONCLUSION:
Although the overall survival rate of patients treated with ECMO for postoperative ARDS was unfavorable, ECMO offered an invaluable opportunity for survival to patients who would not have been expected to survive using conventional therapy. CVVHD may be beneficial in improving the outcomes of such patients, whereas a prolonged duration of pre-ECMO ventilator support was associated with poor survival.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pronóstico
/
Síndrome de Dificultad Respiratoria
/
Ventilación
/
Oxigenación por Membrana Extracorpórea
/
Ventiladores Mecánicos
/
Tasa de Supervivencia
/
Diálisis Renal
/
Trasplante de Hígado
/
Sobrevivientes
Tipo de estudio:
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
The Korean Journal of Thoracic and Cardiovascular Surgery
Año:
2015
Tipo del documento:
Artículo
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