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

Soo Jin Na, Jae-Seung Jung, Sang Bum Hong, Woo Hyun Cho, Sang Min Lee, Young Jae Cho, Sunghoon Park, So My Koo, Seung Yong Park, Youjin Chang, Byung Ju Kang, Jung Hyun Kim, Jin Young Oh, So Hee Park, Jung Wan Yoo, Yun Su Sim, Kyeongman Jeon

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Abstract

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.

Original languageEnglish
JournalTherapeutic Advances in Respiratory Disease
Volume13
DOIs
Publication statusPublished - 2019 May 1

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Extracorporeal Membrane Oxygenation
Respiratory Insufficiency
Hospital Mortality
Mortality
Republic of Korea
Interstitial Lung Diseases
Artificial Respiration
Survival Rate

Keywords

  • acute respiratory failure
  • extracorporeal life support
  • long-term care
  • outcomes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Pharmacology (medical)

Cite this

Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support. / Na, Soo Jin; Jung, Jae-Seung; Hong, Sang Bum; Cho, Woo Hyun; Lee, Sang Min; Cho, Young Jae; Park, Sunghoon; Koo, So My; Park, Seung Yong; Chang, Youjin; Kang, Byung Ju; Kim, Jung Hyun; Oh, Jin Young; Park, So Hee; Yoo, Jung Wan; Sim, Yun Su; Jeon, Kyeongman.

In: Therapeutic Advances in Respiratory Disease, Vol. 13, 01.05.2019.

Research output: Contribution to journalArticle

Na, SJ, Jung, J-S, Hong, SB, Cho, WH, Lee, SM, Cho, YJ, Park, S, Koo, SM, Park, SY, Chang, Y, Kang, BJ, Kim, JH, Oh, JY, Park, SH, Yoo, JW, Sim, YS & Jeon, K 2019, 'Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support', Therapeutic Advances in Respiratory Disease, vol. 13. https://doi.org/10.1177/1753466619848941
Na, Soo Jin ; Jung, Jae-Seung ; Hong, Sang Bum ; Cho, Woo Hyun ; Lee, Sang Min ; Cho, Young Jae ; Park, Sunghoon ; Koo, So My ; Park, Seung Yong ; Chang, Youjin ; Kang, Byung Ju ; Kim, Jung Hyun ; Oh, Jin Young ; Park, So Hee ; Yoo, Jung Wan ; Sim, Yun Su ; Jeon, Kyeongman. / Clinical outcomes of patients receiving prolonged extracorporeal membrane oxygenation for respiratory support. In: Therapeutic Advances in Respiratory Disease. 2019 ; Vol. 13.
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abstract = "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.",
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AU - Na, Soo Jin

AU - Jung, Jae-Seung

AU - Hong, Sang Bum

AU - Cho, Woo Hyun

AU - Lee, Sang Min

AU - Cho, Young Jae

AU - Park, Sunghoon

AU - Koo, So My

AU - Park, Seung Yong

AU - Chang, Youjin

AU - Kang, Byung Ju

AU - Kim, Jung Hyun

AU - Oh, Jin Young

AU - Park, So Hee

AU - Yoo, Jung Wan

AU - Sim, Yun Su

AU - Jeon, Kyeongman

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N2 - 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.

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KW - extracorporeal life support

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