Transition to routine use of venoarterial extracorporeal oxygenation during lung transplantation could improve early outcomes
| Autor: | Jee Won Shu, Hyo Chae Paik, Woo Sik Yu, Chang Young Lee, Jin Gu Lee, Young Woo Do, Kyung Sik Nam, Seok Jin Haam, Hee Suk Jung |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Vital capacity business.industry medicine.medical_treatment 030204 cardiovascular system & hematology Group B Extracorporeal Surgery law.invention 03 medical and health sciences FEV1/FVC ratio 0302 clinical medicine 030228 respiratory system law Anesthesia Cardiopulmonary bypass Extracorporeal membrane oxygenation Medicine Lung transplantation Original Article Fresh frozen plasma business |
| Zdroj: | Journal of Thoracic Disease. 8:1712-1720 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2016.06.18 |
| Popis: | Background: The study objective was to compare the outcomes of intraoperative routine use of venoarterial (VA) extracorporeal membrane oxygenation (ECMO) versus selective use of cardiopulmonary bypass (CPB). Methods: Between January 2010 and February 2013, 41 lung transplantations (LTx) were performed, and CPB was used as a primary cardiopulmonary support modality by selective basis (group A). Between March 2013 and December 2014, 41 LTx were performed, and ECMO was used routinely (group B). The two groups were compared retrospectively. Results: The operative time was significantly longer in group A (group A, 458 min; group B, 420 min; P=0.041). Postoperatively, patients in group B had less fresh frozen plasma (FFP) transfusion (P=0.030). Complications were not different between the two groups. The 30- and 90-day survival rates were better in group B (30-day survival: group A, 75.6%; group B, 95.1%, P=0.012; 90-day survival: group A, 68.3%; group B, 87.8%, P=0.033). The 1-year survival showed better trends in group B, but it was not significant. Forced vital capacity (FVC) at 1, 3, and 6 months after LTx was better in group B than in group A (1 month: group A, 43.8%; group B, 52.9%, P=0.043; 3 months: group A, 45.5%; group B, 59.0%, P=0.005; 6 months: group A, 51.5%; group B, 65.2%, P=0.020). Forced expiratory volume in 1 second (FEV1) at 3 months after LTx was better in patients in group B than that in patient in group A (group A, 53.3%; group B, 67.5%, P=0.017). Conclusions: Routine use of ECMO during LTx could improve early outcome and postoperative lung function without increased extracorporeal-related complication such as vascular and neurologic complications. |
| Databáze: | OpenAIRE |
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