Hospital survival outcomes in acute respiratory distress syndrome patients receiving veno-venous extracorporeal membrane oxygenation for longer than 28 days: A retrospective study
Hospital survival outcomes in acute respiratory distress syndrome patients receiving veno-venous extracorporeal membrane oxygenation for longer than 28 days: A retrospective study
复制标题
接受静脉-静脉体外膜氧合超过 28 天的急性呼吸窘迫综合征患者的医院生存结果：一项回顾性研究
DOI：
10.1111/aor.14051
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发表时间：
2021
期刊：
影响因子：
2.4
通讯作者：
Sakamoto A
中科院分区：
文献类型：
--
作者：
Umei N;Ichiba S;Genda Y;Mase H;Sakamoto A
静脉-静脉体外膜氧合(V-V ECMO)的成功应用越来越多地被报道。然而，关于其结果的数据有限。本研究调查了长期ECMO支持对急性呼吸窘迫综合征(ARDS)患者的转归。我们回顾评估了2015至2020年间57名需要V-V ECMO治疗ARDS的患者。按持续时间分为两组：(A)≤28天组(n=43，75%)或(B)>；28天组(n=14，25%)。统计比较两组患者的临床特征、并发症和预后。两组患者在人口学、合并症、ARDS病因和严重程度评分方面没有显著差异。然而，28天组开始体外反搏前的机械通气期明显长于≤28天组(10.5天vs.1天；P<；0.05)。体外反搏期间，28天组的细菌培养阳性率显著高于≤28天组(43%vs.9%；P<；0.05)。此外，28天组的住院存活率显著低于≤28天组(21%vs.60%；P<；0.05)。ECMO时间延长与较差的医院生存结局相关。早期开始ECMO，并在ECMO期间进行细致的护理和针对感染的适当治疗，可以提高ARDS患者在长期ECMO支持下的住院存活率。
The successful use of prolonged (ie, >28 days) veno‐venous extracorporeal membrane oxygenation (V‐V ECMO) is being increasingly reported. However, limited data are available on its outcomes. This study investigated the outcomes of acute respiratory distress syndrome (ARDS) patients on prolonged ECMO support. We retrospectively evaluated 57 patients requiring V‐V ECMO for ARDS between 2015 and 2020. The patients were divided into two groups according to ECMO duration: (a) ≤28 days group (n = 43, 75%) or (b) >28 days (n = 14, 25%) group. Clinical characteristics, complications, and outcomes between these two groups were statistically compared. There were no significant differences in demographics, comorbidity, ARDS etiology, and severity scores between the two groups. However, the mechanical ventilation period before ECMO initiation was significantly longer in the >28 days group than in the ≤28 days group (10.5 days vs. 1 day;P< .05). The incidence of positive bacterial blood culture results during ECMO was significantly higher in the >28 days group than in the ≤28 days group (43% vs. 9%;P< .05). Additionally, the hospital survival rate was significantly lower in the >28 days group than in the ≤28 days ECMO group (21% vs. 60%;P< .05). Prolonged ECMO was associated with worse hospital survival outcomes. Early initiation of ECMO along with meticulous care and appropriate treatment against infection during ECMO could improve the hospital survival of ARDS patients on prolonged ECMO support.