Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2019 Sep 20;132(18):2192-2198.
doi: 10.1097/CM9.0000000000000424.

Venovenous extra-corporeal membrane oxygenation for severe acute respiratory distress syndrome: a matched cohort study

Song-Qiao Liu  1 , Ying-Zi Huang  1 , Chun Pan  1 , Lan-Qi Guo  1 , Xiao-Ting Wang  2 , Wen-Kui Yu  3 , Yun-Fu Wu  4 , Jie Yan  5 , Hong-Sheng Zhao  6 , Ling Liu  1 , Feng-Mei Guo  1 , Jing-Yuan Xu  1 , Yi Yang  1 , Hai-Bo Qiu  1
Affiliations
Multicenter Study

Venovenous extra-corporeal membrane oxygenation for severe acute respiratory distress syndrome: a matched cohort study

Song-Qiao Liu et al. Chin Med J (Engl). .

Abstract

Background: Although the use of extra-corporeal membrane oxygenation (ECMO) has been rapidly increasing, the benefit of ECMO in patients with acute respiratory distress syndrome (ARDS) remains unclear. Our objective was to investigate the effect of venovenous ECMO (VV-ECMO) on adult patients with severe ARDS.

Methods: We conducted a multi-center, retrospective, cohort study in the intensive care units (ICUs) of six teaching hospitals between January 2013 and December 2018. Patients with severe ARDS who received VV-ECMO support were included. The detailed demographic data and physiologic data were used to match ARDS patients without ECMO. The primary endpoint was the 28-day mortality.

Results: Ninety-nine patients with severe ARDS supported by VV-ECMO and 72 patients without ECMO were included in this study. The acute physiology and chronic health evaluation II score was 23.1 ± 6.3 in the ECMO group and 24.8 ± 8.5 in the control group (P = 0.1195). The sequential organ failure assessment score was 12.8 ± 3.4 in the ECMO group and 13.7 ± 3.5 in the control group (P = 0.0848). The 28-day mortality of patients with ECMO support was 39.4%, and that of the control group was 55.6%. The survival analysis curve showed that the 28-day mortality in the ECMO group was significantly lower than that in the control group (P = 0.0097). Multivariate Cox regression analysis showed that the independent predictors of the 28-day mortality were the requirement of vasopressors before ECMO (hazard ratio [HR]: 1.006; 95% confidence interval [CI]: 1.001-1.013; P = 0.030) and duration of mechanical ventilation before ECMO (HR: 3.299; 95% CI: 1.264-8.609; P = 0.034).

Conclusions: This study showed that ECMO improved the survival of patients with severe ARDS. The duration of mechanical ventilation and the requirement of vasopressors before ECMO might be associated with an increased risk of death.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Effects of ECMO on the outcome of patients with severe ARDS. The survival analysis curve shows that the mortality during the first 28 days in the ECMO group is significantly lower than that in the control group, and the difference is statistically significant (P = 0.0097). ARDS: Acute respiratory distress syndrome; ECMO: Extra-corporeal membrane oxygenation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016; 315:788–800. doi: 10.1001/jama.2016.0291. - PubMed
    1. Force ADT, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, et al. Acute respiratory distress syndrome: the Berlin definition. JAMA 2012; 307:2526–2533. doi: 10.1001/jama.2012.5669. - PubMed
    1. Ferguson ND, Fan E, Camporota L, Antonelli M, Anzueto A, Beale R, et al. The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material. Intensive Care Med 2012; 38:1573–1582. doi: 10.1007/s00134-012-2682-1. - PubMed
    1. Abrams D, Brodie D. Extracorporeal membrane oxygenation for adult respiratory failure: 2017 update. Chest 2017; 152:639–649. doi: 10.1016/j.chest.2017.06.016. - PubMed
    1. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009; 374:1351–1363. doi: 10.1016/S0140-6736(09)61069-2. - PubMed

Publication types