TITLE

Is it possible to predict outcome in pulmonary ECMO? Analysis of pre-operative risk factors

AUTHOR(S)
Wagner, K.; Risnes, I.; Abdelnoor, M.; Karlsen, H. M.; Svennevig, J. L.
PUB. DATE
March 2008
SOURCE
Perfusion;Mar2008, Vol. 23 Issue 2, p95
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Serious pulmonary failure may be treated with extracorporeal membrane oxygenation (ECMO) when other treatment has failed. The aim of this study was to analyze preoperative risk factors of early mortality in patients who underwent either veno-arterial (VA) ECMO or venovenous (VV) ECMO for pulmonary failure. We studied a total of 26 risk factors in 72 patients with severe pulmonary insufficiency treated with ECMO. All consecutive cases treated at our institution between Sept 1990 and Aug 2007 were included. Univariate analysis and multiple logistic regression analysis were performed on 26 risk factors. The end point was early mortality (any death within 30 days of ECMO treatment). Thirty-six (50%) of the patients died within 30 days of treatment. Age, gender, body mass index(BMI)(adults), cause of pulmonary failure, pre-ECMO treatment with nitric oxide (NO), intra-aortic balloon pump(IABP), and type of ventilation did not significantly influence early mortality. Neither pre-operative blood gas results, oxygenation index or pre-operative PaO2/FiO2 ratio, nor mean ventilator days prior to ECMO gave any indications on early mortality. Liver function did not predict early mortality, but pre-ECMO serum creatinine levels were significantly lower in patients who survived. Treatment with ECMO in patients with severe pulmonary failure may save lives. It is, however, difficult to predict outcome when initiating ECMO. In this analysis, only pre-operative serum creatinine levels correlated with survival. None of the other parameters, including those which were used to select patients for ECMO treatment, could significantly predict the outcome.
ACCESSION #
34706124

 

Related Articles

  • Developmental outcome in newborn infants treated for acute respiratory failure with extracorporeal membrane oxygenation: present experience. Khambekar, K.; Nichani, S.; Luyt, D. K.; Peek, G.; Firmin, R. K.; Field, D. J.; Pandya, H. C. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Jan2006, Vol. 91 Issue 1, pF21 

    Objective: To describe the later health status of newborn infants who received extracorporeal membrane oxygenation (ECMO) for acute respiratory failure in the era after the UK ECMO trial. Design: Prospective follow up study of newborn infants who received ECMO at a single centre between January...

  • Referral pattern of neonates with severe respiratory failure for extracorporeal membrane oxygenation. Tiruvoipati, R.; Pandya, H.; Manktelow, B.; Smith, J.; Dodkins, I.; Elbourne, D.; Field, D. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Mar2008, Vol. 93 Issue 2, pF104 

    Background: Extracorporeal membrane oxygenation (ECMO) remains the mainstay of management in neonates with severe but potentially reversible respiratory failure. In the UK, ECMO is available only as a supraregional service at four centres. Objective: To explore regional variations in ECMO...

  • Severe Acute Respiratory Failure Due to Legionella Pneumonia Treated with Extracorporeal... Ichiba, Shingo; Jenkins, David R.; Peek, Giles J.; Brennan, Kevin J.; Killer, Hilliary M.; Sosnowski, Andrezj; Firmin, Richard K. // Clinical Infectious Diseases;3/1/1999, Vol. 28 Issue 3, p686 

    Studies extracorporeal membrane oxygenation (ECMO) therapy for patients with severe acute respiratory failure. Expected mortality rate with conventional treatment; Mechanical complications related to ECMO circuit; Association of epistaxis with nasogastric tube insertion; Deterioration of a...

  • Acute lung injury after mechanical circulatory support implantation in patients on extracorporeal life support: an unrecognized problem†. Boulate, David; Luyt, Charles-Edouard; Pozzi, Matteo; Niculescu, Michaela; Combes, Alain; Leprince, Pascal; Kirsch, Matthias // European Journal of Cardio-Thoracic Surgery;Sep2013, Vol. 44 Issue 3, p544 

    OBJECTIVES We observed early acute lung injury (ALI) after a switch from veno-arterial extracorporeal life support (VA-ECLS) to long-term mechanical circulatory support (MCS). The aim of our study was to analyse the frequency, impact on mortality and characteristics of patients presenting ALI...

  • Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Pappalardo, Federico; Pieri, Marina; Greco, Teresa; Patroniti, Nicolò; Pesenti, Antonio; Arcadipane, Antonio; Ranieri, V.; Gattinoni, Luciano; Landoni, Giovanni; Holzgraefe, Bernhard; Beutel, Gernot; Zangrillo, Alberto // Intensive Care Medicine;Feb2013, Vol. 39 Issue 2, p275 

    Purpose: The decision to start venovenous extracorporeal membrane oxygenation (VV ECMO) is commonly based on the severity of respiratory failure, with little consideration of the extrapulmonary organ function. The aim of the study was to identify predictors of mortality and to develop a score...

  • Efficiency of gas transfer in venovenous extracorporeal membrane oxygenation: analysis of 317 cases with four different ECMO systems. Lehle, Karla; Philipp, Alois; Hiller, Karl-Anton; Zeman, Florian; Buchwald, Dirk; Schmid, Christof; Dornia, Christian; Lunz, Dirk; Müller, Thomas; Lubnow, Matthias // Intensive Care Medicine;Dec2014, Vol. 40 Issue 12, p1870 

    Purpose: Polymethylpentene membrane oxygenators used in venovenous extracorporeal membrane oxygenation (vvECMO) differ in their physical characteristics. The aim of the study was to analyze the gas transfer capability of different ECMO systems in clinical practice, as the choice of the...

  • CESAR support ECMO over conventional ventilatory support.  // PharmacoEconomics & Outcomes News;10/3/2009, Issue 588, p4 

    The article discusses the results of the CESAR trial. According to this trial, ECMO appears to be associated with better outcomes in adult patients with severe reversible respiratory failure compared with conventional ventilatory support. The researchers randomised 180 patients with severe...

  • Cost effectiveness analysis of neonatal extracorporeal membrane oxygenation based on four year results from the UK Collaborative ECMO Trial. Pefrou, S.; Edwards, L. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;May2004, Vol. 89 Issue 3, pF263 

    Objective: To assess the cost effectiveness of extracorporeal membrane oxygenation (ECMO) For mature newborn infants with severe respiratory failure over a four year time span. Design: Cost effectiveness analysis based on a randomised controlled trial in which infants were individually allocated...

  • The use of continuous renal replacement therapy in series with extracorporeal membrane oxygenation. Santiago, Maria J.; Sánchez, Amelia; López-Herce, Jesús; Pérez, Rosario; del Castillo, Jimena; Urbano, Javier; Carrillo, Angel // Kidney International;Dec2009, Vol. 76 Issue 12, p1289 

    A large percentage of patients on extracorporeal membrane oxygenation (ECMO) require continuous renal replacement therapy (CRRT) usually performed through a different venous access or by introducing a filter into the ECMO circuit. Here, we evaluated the efficacy and safety of including a CRRT...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics