The Feasibility of Venovenous Extracorporeal Life Support to Treat Acute Respiratory Failure in Adult Cancer Patients

Meng Yu Wu, Tzu I. Wu, Yuan His Tseng, Wen Chi Shen, Yu Sheng Chang, Chung Chi Huang, Pyng Jing Lin

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Venovenous extracorporeal life support (VV-ECLS) is a lifesaving but invasive treatment for acute respiratory failure (ARF) that is not improved with conventional therapy. However, using VV-ECLS to treat ARF in adult cancer patients is controversial. This retrospective study included 14 cancer patients (median age: 58 years [interquartile range: 51-66]; solid malignancies in 13 patients and hematological malignancy in 1 patient) who received VV-ECLS for ARF that developed within 3 months after anticancer therapies. VV-ECLS would be considered in selected patients with a P aO2/Fi O2 ratio ≤70mmHg under advanced mechanical ventilation. Before ECLS, the medians of intubation day, P aO2/Fi O2 ratio, and Sequential Organ Failure Assessment (SOFA) score were 8 (2-12), 62mmHg (53-76), and 10 (9-14), respectively. The case numbers of bacteremia, thrombocytopenia (platelet count aO2/Fi O2 ratio but not in SOFA score. Six patients experienced major hemorrhages during ECLS. The median ECLS day, ECLS weaning rate, and hospital survival were 11 (7-16), 50% (n=7), and 29% (n=4). The development of dialysis-dependent nephropathy predicted death on ECLS (odds ratio: 36; 95% confidence interval: 1.8-718.7; P=0.01). With a median follow-up of 11 (6-43) months, half of the survivors died of cancer recurrence and the others were in partial remission. The most prominent benefit of VV-ECLS is to improve the arterial oxygenation and rest the lungs. This may increase the chance of recovery from ARF in selected cancer patients.

Original languageEnglish
Article numbere893
JournalMedicine (United States)
Volume94
Issue number21
DOIs
Publication statusPublished - May 5 2015

ASJC Scopus subject areas

  • Medicine(all)

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