Extracorporeal membrane oxygenation in adult patients with severe acute respiratory failure

Autor: P. Sprogoe, Christian Lindskov, A. G Lorentsen, Susanne Ilkjær, C. M. Pedersen, Lars Folkersen, Reinhold Jensen, Inge Krogh Severinsen, Kaj-Erik Klaaborg, Hans Kirkegaard
Rok vydání: 2012
Předmět:
Zdroj: Acta Anaesthesiologica Scandinavica. 57:303-311
ISSN: 0001-5172
DOI: 10.1111/aas.12050
Popis: Background A group of patients with severe acute respiratory distress syndrome (ARDS) is resistant to advanced respiratory therapy. In these patients, extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy. This study presents 14 years of experience from a Scandinavian ECMO centre. The aim of the study is to present outcome results and to investigate whether or not simplified acute physiology score II (SAPS-II), sequential organ failure assessment (SOFA) and/or Murray scores can be used to predict patients' outcome. Methods In a prospective observational study, we collected data from ECMO patients from January 1997 to March 2011. The treatment was based mainly on venous-venous ECMO and centrifugal pumps. Patients were retrieved from Denmark plus a number from Sweden and Norway. The inclusion criteria were the classical criteria until November 2009 (n = 100), after which the new Extracorporeal Life Support Organisation criteria (n = 24) were used. Results One hundred and twenty-four patients were enrolled with median age 45 (range 16–67) years. The median Murray score was 3.7 (2.5–4.0). One hundred and six (85%) of the patients were retrieved from referring hospitals on ECMO. The median duration of the ECMO runs was 215 (1–578) h. Ninety-seven (78%) of the patients could be weaned from ECMO. A total of 88 (71%) were discharged alive to the referring hospitals. High SAPS-II, SOFA and Murray scores were associated with a high mortality. Conclusion Patients with severe ARDS have a favourable outcome when treated with ECMO and when an ECMO retrieval team establishes the ECMO treatment at the referring hospital. SAPS-II, SOFA and Murray scores predicted the outcome.
Databáze: OpenAIRE
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