The outcome of patients requiring multiple extracorporeal membrane oxygenation: How many runs of ECMO is reasonable?

Heng Wen Chou, Te I. Chang, Chih Hsien Wang, Nai Kuan Chou, Nai Hsin Chi, Shu Chien Huang, I. Hui Wu, Chih Yang Chan, Lee Mei Ponge, Ya Chen Wang, Yih Sharng Chen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been proven effective in life support for patients with refractory cardiopulmonary failure. Deteriorating patients who have removed their first ECMO support and required second or more courses of ECMO support have rarely been discussed. Methods and results: All the records of the patients who experienced at least 2 courses of ECMO during single admission were retrieved. Survival was defined as survival to discharge. Demographic data and clinical information were compared between survival and nonsurvival groups. There were 86 patients who received at least 2 courses of ECMO in the 20-year database, and 27 (31.3%) were <18 years old. Of them, 87.3% received 2 runs of ECMO, 10.4% 3 runs, and 2.3% 4 runs. Overall survival rate was 30.2%. The survival rate for patients with 2 runs of ECMO was 33.3% (25 out of 75), 11.1% (1 out of 9) for 3 runs, and 0% (0 out of 2) for 4 runs. Multivariate analysis revealed that only ARF with hemodialysis was the independent risk factor. Conclusions: The decision to perform repeated ECMO implantation is a complex and difficult process. Despite the arguments debating the consumption of resources and increased complications, there are still nearly 1 out of 3 patients who will survive to discharge. More than 2 courses of ECMO may be carefully considered for further rescue.

Original languageEnglish
Pages (from-to)288-293
Number of pages6
JournalInternational Journal of Artificial Organs
Volume39
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

Fingerprint

Extracorporeal Membrane Oxygenation
Oxygenation
Membranes
Survival
Survival Rate
Refractory materials
Renal Dialysis
Multivariate Analysis
Demography
Databases

Keywords

  • Cardiopulmonary failure
  • Multiple extracorporeal membrane oxygenation
  • Survival

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this

The outcome of patients requiring multiple extracorporeal membrane oxygenation : How many runs of ECMO is reasonable? / Chou, Heng Wen; Chang, Te I.; Wang, Chih Hsien; Chou, Nai Kuan; Chi, Nai Hsin; Huang, Shu Chien; Wu, I. Hui; Chan, Chih Yang; Ponge, Lee Mei; Wang, Ya Chen; Chen, Yih Sharng.

In: International Journal of Artificial Organs, Vol. 39, No. 6, 01.06.2016, p. 288-293.

Research output: Contribution to journalArticle

Chou, HW, Chang, TI, Wang, CH, Chou, NK, Chi, NH, Huang, SC, Wu, IH, Chan, CY, Ponge, LM, Wang, YC & Chen, YS 2016, 'The outcome of patients requiring multiple extracorporeal membrane oxygenation: How many runs of ECMO is reasonable?', International Journal of Artificial Organs, vol. 39, no. 6, pp. 288-293. https://doi.org/10.5301/ijao.5000511
Chou, Heng Wen ; Chang, Te I. ; Wang, Chih Hsien ; Chou, Nai Kuan ; Chi, Nai Hsin ; Huang, Shu Chien ; Wu, I. Hui ; Chan, Chih Yang ; Ponge, Lee Mei ; Wang, Ya Chen ; Chen, Yih Sharng. / The outcome of patients requiring multiple extracorporeal membrane oxygenation : How many runs of ECMO is reasonable?. In: International Journal of Artificial Organs. 2016 ; Vol. 39, No. 6. pp. 288-293.
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abstract = "Background: Extracorporeal membrane oxygenation (ECMO) has been proven effective in life support for patients with refractory cardiopulmonary failure. Deteriorating patients who have removed their first ECMO support and required second or more courses of ECMO support have rarely been discussed. Methods and results: All the records of the patients who experienced at least 2 courses of ECMO during single admission were retrieved. Survival was defined as survival to discharge. Demographic data and clinical information were compared between survival and nonsurvival groups. There were 86 patients who received at least 2 courses of ECMO in the 20-year database, and 27 (31.3{\%}) were <18 years old. Of them, 87.3{\%} received 2 runs of ECMO, 10.4{\%} 3 runs, and 2.3{\%} 4 runs. Overall survival rate was 30.2{\%}. The survival rate for patients with 2 runs of ECMO was 33.3{\%} (25 out of 75), 11.1{\%} (1 out of 9) for 3 runs, and 0{\%} (0 out of 2) for 4 runs. Multivariate analysis revealed that only ARF with hemodialysis was the independent risk factor. Conclusions: The decision to perform repeated ECMO implantation is a complex and difficult process. Despite the arguments debating the consumption of resources and increased complications, there are still nearly 1 out of 3 patients who will survive to discharge. More than 2 courses of ECMO may be carefully considered for further rescue.",
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AU - Chou, Heng Wen

AU - Chang, Te I.

AU - Wang, Chih Hsien

AU - Chou, Nai Kuan

AU - Chi, Nai Hsin

AU - Huang, Shu Chien

AU - Wu, I. Hui

AU - Chan, Chih Yang

AU - Ponge, Lee Mei

AU - Wang, Ya Chen

AU - Chen, Yih Sharng

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N2 - Background: Extracorporeal membrane oxygenation (ECMO) has been proven effective in life support for patients with refractory cardiopulmonary failure. Deteriorating patients who have removed their first ECMO support and required second or more courses of ECMO support have rarely been discussed. Methods and results: All the records of the patients who experienced at least 2 courses of ECMO during single admission were retrieved. Survival was defined as survival to discharge. Demographic data and clinical information were compared between survival and nonsurvival groups. There were 86 patients who received at least 2 courses of ECMO in the 20-year database, and 27 (31.3%) were <18 years old. Of them, 87.3% received 2 runs of ECMO, 10.4% 3 runs, and 2.3% 4 runs. Overall survival rate was 30.2%. The survival rate for patients with 2 runs of ECMO was 33.3% (25 out of 75), 11.1% (1 out of 9) for 3 runs, and 0% (0 out of 2) for 4 runs. Multivariate analysis revealed that only ARF with hemodialysis was the independent risk factor. Conclusions: The decision to perform repeated ECMO implantation is a complex and difficult process. Despite the arguments debating the consumption of resources and increased complications, there are still nearly 1 out of 3 patients who will survive to discharge. More than 2 courses of ECMO may be carefully considered for further rescue.

AB - Background: Extracorporeal membrane oxygenation (ECMO) has been proven effective in life support for patients with refractory cardiopulmonary failure. Deteriorating patients who have removed their first ECMO support and required second or more courses of ECMO support have rarely been discussed. Methods and results: All the records of the patients who experienced at least 2 courses of ECMO during single admission were retrieved. Survival was defined as survival to discharge. Demographic data and clinical information were compared between survival and nonsurvival groups. There were 86 patients who received at least 2 courses of ECMO in the 20-year database, and 27 (31.3%) were <18 years old. Of them, 87.3% received 2 runs of ECMO, 10.4% 3 runs, and 2.3% 4 runs. Overall survival rate was 30.2%. The survival rate for patients with 2 runs of ECMO was 33.3% (25 out of 75), 11.1% (1 out of 9) for 3 runs, and 0% (0 out of 2) for 4 runs. Multivariate analysis revealed that only ARF with hemodialysis was the independent risk factor. Conclusions: The decision to perform repeated ECMO implantation is a complex and difficult process. Despite the arguments debating the consumption of resources and increased complications, there are still nearly 1 out of 3 patients who will survive to discharge. More than 2 courses of ECMO may be carefully considered for further rescue.

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