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. 2015 Jul;30(4):478-88.
doi: 10.3904/kjim.2015.30.4.478. Epub 2015 Jun 29.

Clinical outcomes of extracorporeal membrane oxygenation support in patients with hematologic malignancies

Hye Seon Kang  1 , Chin Kook Rhee  1 , Hea Yon Lee  1 , Young Kyoon Kim  1 , Soon Seog Kwon  1 , Seok Chan Kim  1 , Jong Wook Lee  2
Affiliations

Clinical outcomes of extracorporeal membrane oxygenation support in patients with hematologic malignancies

Hye Seon Kang et al. Korean J Intern Med. 2015 Jul.

Abstract

Background/aims: The clinical outcomes of patients with hematologic malignancies who were treated with extracorporeal membrane oxygenation (ECMO) after the failu re of optimal conventional therapy were determined.

Methods: The medical records of all patients administered ECMO during their stay in a medical intensive care unit of Seoul St. Mary's Hospital between February 2010 and July 2013 were reviewed retrospectively.

Results: In total, 15 patients with hematologic malignancies were compared to 33 immunocompetent patients with documented cardiorespiratory failure. Underlying hematologic malignancies were significantly associated with lower overall survival (0.0% vs. 24.2%, p = 0.044). Mortality was significantly associated with a higher 24 hours ECMO inspired fraction of oxygen (0.71 ± 0.24 vs. 0.47 ± 0.13, p = 0.015), the development of infection after ECMO (87.5% vs. 25.0%, p = 0.001), and the presence of hyperbilirubinemia (70.0% vs. 0.0%, p < 0.001). Matching of the patients based on their Acute Physiology and Chronic Health Evaluation II scores confirmed the greater risk of mortality in patients with hematologic malignancies (survival: 0.0% vs. 40.0%, p = 0.017). The mean difference in inotropic-equivalent scores after ECMO was significantly lower in the immunocompetent patients than in those with hematologic malignancies (-59.22 ± 97.83 vs. 53.87 ± 164.46, p = 0.026).

Conclusions: Patients with hematologic malignancies who require ECMO for respiratory support have poor outcomes. The incidence of complications in these patients did not significantly differ from that in immunocompetent patients.

Keywords: Adults; Complications; Extracorporeal membrane oxygenation; Hematologic neoplasms; Mortality.

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Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1. Kaplan-Meier survival analysis of patients with hematologic malignancies and immunocompetent controls matched for their Acute Physiology and Chronic Health Evaluation II scores. The survival distribution of the two groups was compared using a log-rank test. Median survival was 8.00 days versus 13.00 days, respectively.
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