Korean J Thorac Cardiovasc Surg.  2012 Apr;45(2):91-94. 10.5090/kjtcs.2012.45.2.91.

Outcomes of Venovenous Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome in Adults

• Ma DS
• Kim JB
• Jung SH
• Choo SJ
• Chung CH
• Lee JW

• KMID: 1433669
• DOI: http://doi.org/10.5090/kjtcs.2012.45.2.91

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.

Keyword

Acute respiratory distress syndrome; Extracorporeal membrane oxygenation

MeSH Terms

Adult
Extracorporeal Membrane Oxygenation
Humans
Inhalation
Logistic Models
Nitric Oxide
Renal Replacement Therapy
Respiratory Distress Syndrome, Adult
Retrospective Studies
Shock
Weaning
Nitric Oxide