Is There a Preinterventional Mechanical Ventilation Time Limit for Candidates of Adult Respiratory Extracorporeal Membrane Oxygenation

Meng Yu Wu, Chung Chi Huang, Tzu I. Wu, Yu Sheng Chang, Chin Liang Wang, Pyng Jing Lin

研究成果: 雜誌貢獻文章

1 引文 斯高帕斯(Scopus)

摘要

Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality. This retrospective study included 129 adult patients receiving VV-ECMO for ARDS in a single institution from 2007 to 2016. Important demographic and clinical data before ECMO intervention were collected for analyses of in-hospital mortality. The MV time before ECMO independently predicted hospital death in adult respiratory ECMO here. Although compared with the patients receiving MV for 7 days or less, the patients receiving MV for more than 7 days before ECMO showed a higher in-hospital mortality rate (77% vs. 38%; p < 0.001). The patients receiving MV for more than 7 days before ECMO also showed obvious deterioration in respiratory function during prolonged MV before the institution of ECMO. Therefore, from the clinical observation, we thought that a 7 day period might be an acceptable limit on MV time before institution of VV-ECMO. Integrating other respiratory parameters into the current PaO2/FiO2 (PF) ratio-based inclusion criteria of adult respiratory ECMO might be helpful to reduce the risk of prolonged MV in selected patients.

原文英語
期刊ASAIO Journal
DOIs
出版狀態接受/付印 - 五月 18 2017

ASJC Scopus subject areas

  • Bioengineering
  • Biophysics
  • Medicine(all)
  • Biomaterials
  • Biomedical Engineering

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