scholarly journals Respiratory failure after lung transplantation: extracorporeal membrane oxygenation as a rescue treatment

Clinics ◽  
2012 ◽  
Vol 67 (12) ◽  
pp. 1529-1532 ◽  
Author(s):  
PM Pego-Fernandes ◽  
LA Hajjar ◽  
FR Galas ◽  
MN Samano ◽  
AK Ribeiro ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Membrane Oxygenation ◽  
Rescue Treatment

scholarly journals The Role of Awake Extracorporeal Membrane Oxygenation as Bridging Therapy for Lung Transplantation: A Retrospective Cohort Study

2020 ◽  
Author(s):  
NAM EUN KIM ◽  
Song Yee Kim ◽  
Ah Young Leem ◽  
Youngmok Park ◽  
Se Hyun Kwak ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Predictive Factor ◽  
Apache Ii Score ◽  
Independent Predictive Factor ◽  
Membrane Oxygenation ◽  
Operative Outcomes ◽  
Rescue Treatment ◽  
Risk Patients ◽  
End Stage

Abstract Background As lung transplantation (LTx) becomes a standard treatment for end-stage lung disease, bridging to LTx with extracorporeal membrane oxygenation (ECMO) is increasing during waiting time, for either rescue treatment or improving ability to rehabilitation before transplant. This study investigated post-operative outcomes in patients bridging to lung transplantation with ECMO, especially those receiving awake ECMO. Methods In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019. Among them, 65 patients received ECMO support while waiting for LTx; these patients were analyzed according to their awakeness. Multivaribale logistic regression and Cox proportional hazard models were used to analyze variables associated awake strategy and mortality. Results Thirty-three patients (50.7%) were awake during bridging ECMO, and 32 patients (49.2%) were in sedative status. The median age of awake ECMO patients was 59.0 (IQR 54.0-63.0) years, and 63.1% of population was male. There were no significant differences between awake and non-awake ECMO patients with respect to age, comorbidities, APACHE II score, ECMO duration and ECMO blood flow. Awake group have better post-operative outcome in terms of statically shorter post-operative intensive care unit (ICU) length of stay (LOS) (awake vs. non-awake, 6 [4-9.5] vs. 16 [6-22], p = 0.004) and longer ventilator free days (VFDs) (awake vs. non-awake, 24 [11.0-25.0] vs. 0 [0.0-14.5], p = 0.001). Furthermore, the awake ECMO group had a significantly lower six-month mortality rate compared to the non-awake group (18.2% vs. 40.6%, p = 0.045). It was independent predictive factor for ability to gait after LTx ([OR] 4.128, 95% CI 1.094-15.572, p = 0.036). Conclusions Awake ECMO therapy could be useful for high-risk patients waiting for LTx, and might help shorten ICU LOS and improve survival benefit after LTx. Furthermore, awake ECMO was independent predictive factor for postoperative gaiting.

scholarly journals Efficacy of extracorporeal membrane oxygenation for acute respiratory failure with interstitial lung disease; a case control nationwide dataset study in Japan

2021 ◽  
Author(s):  
Yuko Usagawa ◽  
Kosaku Komiya ◽  
Mari Yamasue ◽  
Kiyohide Fushimi ◽  
Kazufumi Hiramatsu ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Interstitial Lung Disease ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Acute Respiratory Failure ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Case Control ◽  
Antifungal Drugs ◽  
Membrane Oxygenation

Abstract Background: Since it is uncertain whether acute respiratory failure in patients with interstitial lung disease is reversible, indications for extracorporeal membrane oxygenation in these patients remain controversial, except for bridging to lung transplantation. The objective of this study was to clarify in-hospital mortality and prognostic factors in interstitial lung disease patients undergoing extracorporeal membrane oxygenation.Methods: Case-control study. Using the Japanese Diagnosis Procedure Combination database from 2010 to 2017, we reviewed hospitalized interstitial lung disease patients receiving invasive mechanical ventilation and extracorporeal membrane oxygenation. As we focused on the efficacy of extracorporeal membrane oxygenation as an intervention for managing merely acute respiratory failure, patients treated with extracorporeal membrane oxygenation as a bridge to lung transplantation were excluded.Results: A total of 164 interstitial lung disease patients receiving extracorporeal membrane oxygenation were included. In-hospital mortality of them was 74.4% (122/164). Compared with survivors, non-survivors were older and received high-dose cyclophosphamide, protease inhibitors, and antifungal drugs more frequently but macrolides and anti-influenza drugs less frequently. Multivariate analysis revealed the following factors were associated with in-hospital mortality: advanced age with an odds ratio (OR) of 1.048 and a 95% confidence interval (CI) of 1.015–1.082, non-use of macrolides (OR, 0.264; 95% CI, 0.118–0.589), and use of antifungal drugs (OR, 3.158; 95% CI, 1.377–7.242).Conclusions: Approximately three quarters of interstitial lung disease patients undergoing extracorporeal membrane oxygenation died in hospital. Moreover, advanced age, non-use of macrolides, and use of antifungal drugs were found to correlate with a poor prognosis.

scholarly journals Efficacy of Extracorporeal Membrane Oxygenation for Acute Respiratory Failure with Interstitial Lung Disease; A Case Control Nationwide Dataset Study in Japan

2021 ◽  
Author(s):  
Yuko Usagawa ◽  
Kosaku Komiya ◽  
Mari Yamasue ◽  
Kiyohide Fushimi ◽  
Kazufumi Hiramatsu ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Interstitial Lung Disease ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Acute Respiratory Failure ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Case Control ◽  
Antifungal Drugs ◽  
Membrane Oxygenation

Abstract Background: Since it is uncertain whether acute respiratory failure in patients with interstitial lung disease is reversible, indications for extracorporeal membrane oxygenation in these patients remain controversial, except for bridging to lung transplantation. The objective of this study was to clarify in-hospital mortality and prognostic factors in interstitial lung disease patients undergoing extracorporeal membrane oxygenation.Study design and Methods: Case-control study. Using the Japanese Diagnosis Procedure Combination database, we reviewed hospitalized interstitial lung disease patients receiving invasive mechanical ventilation and extracorporeal membrane oxygenation for acute respiratory failure from 2010 to 2017. As we focused on the efficacy of extracorporeal membrane oxygenation as an intervention for managing merely acute respiratory failure, patients treated with extracorporeal membrane oxygenation as a bridge to lung transplantation were excluded.Results: A total of 164 interstitial lung disease patients receiving extracorporeal membrane oxygenation were included, 122 of whom (74.4%) died during hospitalization. Compared with survivors, non-survivors were older and received high-dose cyclophosphamide, protease inhibitors, and antifungal drugs more frequently but macrolides and anti-influenza drugs less frequently. Multivariate analysis revealed the following factors were associated with in-hospital mortality: advanced age with an odds ratio (OR) of 1.048 and a 95% confidence interval (CI) of 1.015–1.082, non-use of macrolides (OR, 0.264; 95% CI, 0.118–0.589), and use of antifungal drugs (OR, 3.158; 95% CI, 1.377–7.242).Conclusions: Approximately three quarters of interstitial lung disease patients undergoing extracorporeal membrane oxygenation died in hospital. Moreover, advanced age, non-use of macrolides, and use of antifungal drugs were found to correlate with a poor prognosis.

scholarly journals Extracorporeal Membrane Oxygenation Use in Thoracic Surgery

Membranes ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 416
Author(s):  
Pavel Suk ◽  
Vladimír Šrámek ◽  
Ivan Čundrle
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Thoracic Surgery ◽  
Lung Transplantation ◽  
Case Series ◽  
Narrative Review ◽  
Conventional Ventilation ◽  
Sleeve Lobectomy ◽  
Membrane Oxygenation ◽  
Postoperative Respiratory Failure

This narrative review is focused on the application of extracorporeal membrane oxygenation (ECMO) in thoracic surgery, exclusive of lung transplantation. Although the use of ECMO in this indication is still rare, it allows surgery to be performed in patients where conventional ventilation is not feasible—especially in single lung patients, sleeve lobectomy or pneumonectomy and tracheal or carinal reconstructions. Comparisons with other techniques, various ECMO configurations, the management of anticoagulation, anesthesia, hypoxemia during surgery and the use of ECMO in case of postoperative respiratory failure are reviewed and supported by two cases of perioperative ECMO use, and an overview of published case series.

Sign in / Sign up

Export Citation Format

Share Document