Extracorporeal membrane oxygenation offers long-term survival in childhood leukemia and acute respiratory failure

Veno-venous extracorporeal membrane oxygenation is increasingly used for severe but potentially reversible acute respiratory failure in adults; however, there are limited data regarding long-term morbidity. At our institution, most patients requiring veno-venous extracorporeal membrane oxygenation have been followed up by a single physician. Our primary aim was to describe the serial long-term morbidity for respiratory, musculoskeletal and psychological functioning. A retrospective audit of inpatient and outpatient medical records was conducted. A total of 125 patients treated with veno-venous extracorporeal membrane oxygenation for primary respiratory failure were included. The patients were young (mean (standard deviation) age 43.7 (4.1) years), obese (mean (standard deviation) body mass index 30.8 (10.4) kg/m2), and mostly were male (59%). Most patients (60%) had no comorbidities. The survival rate to discharge was 70%, with body mass index and the number of comorbidities being independent predictors of survival on multiple logistic regression analysis. Over half (57%) of the Australian survivors had regular outpatient follow-up. They had a median of three reviews (range 1–9) over a median of 11.8 months (range 1.5-79) months. Breathlessness and weakness resolved in most within six months, with lung function abnormalities taking longer to resolve. Over half (60%) returned to employment within six months of discharge. Over a quarter (29%) displayed symptoms of anxiety, depression or post-traumatic stress disorder.

Download Full-text

Long-term survival of adults with cardiogenic shock after venoarterial extracorporeal membrane oxygenation

Journal of Critical Care ◽

10.1016/j.jcrc.2015.05.022 ◽

2015 ◽

Vol 30 (5) ◽

pp. 949-956 ◽

Cited By ~ 30

Author(s):

Aidan J.C. Burrell ◽

Vincent A. Pellegrino ◽

Rory Wolfe ◽

Wen Kai Wong ◽

David Jamie Cooper ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Cardiogenic Shock ◽

Term Survival ◽

Long Term Survival ◽

Membrane Oxygenation ◽

Venoarterial Extracorporeal Membrane Oxygenation

Download Full-text

Extracorporeal Membrane Oxygenation for Primary Graft Dysfunction After Lung Transplantation: Long-Term Survival

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2008.11.036 ◽

2009 ◽

Vol 87 (3) ◽

pp. 854-860 ◽

Cited By ~ 82

Author(s):

Christian A. Bermudez ◽

Prasad S. Adusumilli ◽

Kenneth R. McCurry ◽

Diana Zaldonis ◽

Maria M. Crespo ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Lung Transplantation ◽

Primary Graft Dysfunction ◽

Graft Dysfunction ◽

Term Survival ◽

Long Term Survival ◽

Membrane Oxygenation

Download Full-text

Acute respiratory failure in progressive neurological diseases: What is important for intensive care unit and long-term survival?

10.1183/13993003.congress-2016.pa3563 ◽

2016 ◽

Author(s):

Ülgen Yalaz Tekan ◽

Emine Aksoy ◽

Feyza Kargin ◽

Rabia Sari ◽

Cüneyt Saltürk ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Neurological Diseases ◽

Term Survival ◽

Long Term Survival

Download Full-text

Survival after refractory cardiogenic shock is comparable in patients with Impella and veno-arterial extracorporeal membrane oxygenation when adjusted for SAVE score

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872618799745 ◽

2018 ◽

Vol 8 (4) ◽

pp. 329-337 ◽

Cited By ~ 13

Author(s):

Petter Schiller ◽

Laila Hellgren ◽

Per Vikholm

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Cardiogenic Shock ◽

Disease Severity ◽

Term Survival ◽

Long Term Survival ◽

Membrane Oxygenation ◽

Refractory Cardiogenic Shock ◽

Short And Long Term ◽

Va Ecmo

Objectives: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. Methods: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included. Data were analysed to assess short and long-term survival and complications. The SAVE score was calculated for the two groups and outcome was compared adjusted for the SAVE score. Results: There was no difference between VA-ECMO patients ( n=46) and Impella patients ( n=48) in mean age or renal failure. ECMO patients were more often intubated and had lower diastolic blood pressure at device implantation. ECMO patients had a lower SAVE score (–0.4 (6.5)) compared to Impella patients (4.1 (5.4)). There was no difference in intensive care unit survival between ECMO patients 65% (52–80) or Impella patients 63% (55–79), or long-term survival between groups. When stratified into worse (III–IV) or better SAVE class (I–II) there was no difference in survival between the groups. Conclusions: Short and long-term survival is not measurably different among patients treated with Impella or VA-ECMO due to refractory cardiogenic shock, after adjustment for disease severity through the SAVE score.

Download Full-text

Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466619848941 ◽

2019 ◽

Vol 13 ◽

pp. 175346661984894 ◽

Cited By ~ 4

Author(s):

Soo Jin Na ◽

Jae-Seung Jung ◽

Sang-Bum Hong ◽

Woo Hyun Cho ◽

Sang-Min Lee ◽

...

Keyword(s):

Respiratory Failure ◽

Mortality Rate ◽

Extracorporeal Membrane Oxygenation ◽

Hospital Mortality ◽

Acute Respiratory Failure ◽

Ecmo Support ◽

Respiratory Support ◽

Short Term ◽

Membrane Oxygenation

Background: There are limited data regarding prolonged extracorporeal membrane oxygenation (ECMO) support, despite increase in ECMO use and duration in patients with respiratory failure. The objective of this study was to investigate the outcomes of severe acute respiratory failure patients supported with prolonged ECMO for more than 28 days. Methods: Between January 2012 and December 2015, all consecutive adult patients with severe acute respiratory failure who underwent ECMO for respiratory support at 16 tertiary or university-affiliated hospitals in South Korea were enrolled retrospectively. The patients were divided into two groups: short-term group defined as ECMO for ⩽28 days and long-term group defined as ECMO for more than 28 days. In-hospital and 6-month mortalities were compared between the two groups. Results: A total of 487 patients received ECMO support for acute respiratory failure during the study period, and the median support duration was 8 days (4–20 days). Of these patients, 411 (84.4%) received ECMO support for ⩽28 days (short-term group), and 76 (15.6%) received support for more than 28 days (long-term group). The proportion of acute exacerbation of interstitial lung disease as a cause of respiratory failure was higher in the long-term group than in the short-term group (22.4% versus 7.5%, p < 0.001), and the duration of mechanical ventilation before ECMO was longer (4 days versus 1 day, p < 0.001). The hospital mortality rate (60.8% versus 69.7%, p = 0.141) and the 6-month mortality rate (66.2% versus 74.0%, p = 0.196) were not different between the two groups. ECMO support longer than 28 days was not associated with hospital mortality in univariable and multivariable analyses. Conclusions: Short- and long-term survival rates among patients receiving ECMO support for more than 28 days for severe acute respiratory failure were not worse than those among patients receiving ECMO for 28 days or less.

Download Full-text