Original articleGeneral thoracicSurvival Predictors in Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation
Section snippets
Patients
This was a retrospective study of severe ARDS patients who underwent ECMO in the medical and surgical intensive care units at a tertiary care referral center, Chang Gung Memorial Hospital, between May 2006 and December 2011. All patients had severe ARDS defined according to the Berlin definition with acute onset within 1 week, bilateral lung opacities on chest radiograph, no evidence of cardiac failure–related hydrostatic edema by echocardiography, and PaO2 to fraction of inspired oxygen (FiO2)
Patient Characteristics
In all, 81 patients with severe ARDS who received ECMO during the study period were included in the study. After excluding 16 patients (2 patients aged less than 18 years and 14 patients receiving venoarterial ECMO for intractable shock or heart failure), 65 patients were in the final analysis. Of those, 37 patients were successfully weaned from ECMO, and 31 patients survived; 28 patients could not be weaned from ECMO and did not survive (Fig 1). A summary of the demographic data and clinical
Comment
The effectiveness of ECMO for severe ARDS patients and life-threatening hypoxemia is controversial 2, 10. The present retrospective study demonstrated that the mortality rate was 52.3% for patients with severe ARDS who were treated with ECMO, higher than severe ARDS with a mortality rate of 45% according to the Berlin definition, with similar risk categories by PaO2:FiO2 ratio less than 100 mm Hg [1]. Survivors were younger and had significantly shorter duration of MV and lower APACH II, SOFA,
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Cited by (41)
The Ethics of Extracorporeal Membrane Oxygenation: Revisiting the Principles of Clinical Bioethics
2021, Annals of Thoracic SurgeryCitation Excerpt :There is a growing acceptance of and increase in utilization of ECMO.16 Despite this, many remain skeptical and are reluctant to embrace the therapy, often resulting in late referrals to ECMO centers and programs, even though data suggest that early ECMO referral may improve survival.17 It is important to discern a clinician’s role in the doctor–patient encounter and explore the debate of patient and provider autonomy.
Lung Compliance and Outcomes in Patients With Acute Respiratory Distress Syndrome Receiving ECMO
2019, Annals of Thoracic SurgeryCitation Excerpt :Among MV variables (Table 2), lung compliance and RR were selected for the Cox proportional model. We also included the length of MV days in the model because previous research indicated it was significantly associated with patient outcome [20]. In the final models, pre-ECMO lung compliance (and TWA-lung compliance) was significantly associated with 6-month mortality (Table 3).
Extracorporeal membrane oxygenation in circulatory and respiratory failure – A single‐center experience
2017, Revista Portuguesa de CardiologiaA comparison of existing risk prediction models in patients undergoing venoarterial extracorporeal membrane oxygenation
2020, Heart and LungCitation Excerpt :However, these scores were not derived from, nor intended to predict outcomes in VA-ECMO patients. Several survival prediction models for severe respiratory failure requiring venovenous ECMO have been devised.17-21 Only a few such models exist for VA-ECMO.
Prolonged VV ECMO: Navigating the Unchartered Sea
2023, Indian Journal of Critical Care Medicine
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Drs Chiu and Tsai contributed equally to this article.