Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: A multicenter retrospective study in Korean patients 11 Medical and Health Sciences 1103 Clinical Sciences

Moon Seong Baek, Sang Min Lee, Chi Ryang Chung, Woo Hyun Cho, Young Jae Cho, Sunghoon Park, So My Koo, Jae-Seung Jung, Seung Yong Park, Youjin Chang, Byung Ju Kang, Jung Hyun Kim, Jin Young Oh, So Hee Park, Jung Wan Yoo, Yun Su Sim, Sang Bum Hong

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2 Citations (Scopus)

Abstract

Background: Although the utilization of extracorporeal membrane oxygenation (ECMO) is increasing and its technology is evolving, only a few epidemiologic reports have described the uses and outcomes of ECMO. The aim of this study was to investigate the changes in utilization and survival rate in patients supported with ECMO for severe respiratory failure in Korea. Methods: This was a multicenter study on consecutive patients who underwent ECMO across 16 hospitals in Korea. The records of all patients who required ECMO for acute respiratory failure between 2012 and 2015 were retrospectively reviewed, and the utilization of ECMO was analyzed over time. Results: During the study period, 5552 patients received ECMO in Korea as a whole, and a total of 2472 patients received ECMO at the participating 16 hospitals. We analyzed 487 (19.7%) patients who received ECMO for respiratory failure. The number of ECMO procedures provided for respiratory failure increased from 104 to 153 during the study period. The in-hospital survival rate increased from 30.8% to 35.9%. The use of prone positioning increased from 6.8% to 49.0% (p < 0.001), and the use of neuromuscular blockers also increased from 28.2% to 58.2% (p < 0.001). Multiple regression analysis showed that old age (OR 1.038 (95% CI 1.022, 1.054)), use of corticosteroid (OR 2.251 (95% CI 1.153, 4.397)), continuous renal replacement therapy (OR 2.196 (95% CI 1.135, 4.247)), driving pressure (OR 1.072 (95% CI 1.031, 1.114)), and prolonged ECMO duration (OR 1.020 (95% CI 1.003, 1.038)) were associated with increased odds of mortality. Conclusions: Utilization of ECMO and survival rates of patients who received ECMO for respiratory failure increased over time in Korea. The use of pre-ECMO prone positioning and neuromuscular blockers also increased during the same period.

Original languageEnglish
Article number1
JournalCritical Care
Volume23
Issue number1
DOIs
Publication statusPublished - 2019 Jan 3

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Keywords

  • Extracorporeal membrane oxygenation
  • Survival
  • Utilization

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Baek, M. S., Lee, S. M., Chung, C. R., Cho, W. H., Cho, Y. J., Park, S., Koo, S. M., Jung, J-S., Park, S. Y., Chang, Y., Kang, B. J., Kim, J. H., Oh, J. Y., Park, S. H., Yoo, J. W., Sim, Y. S., & Hong, S. B. (2019). Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: A multicenter retrospective study in Korean patients 11 Medical and Health Sciences 1103 Clinical Sciences. Critical Care, 23(1), [1]. https://doi.org/10.1186/s13054-018-2293-5