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
Observational Study
. 2021 Apr 30;51(2):555-561.
doi: 10.3906/sag-2004-308.

Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients

Yunus Emre Özlüer  1 , Mücahit Avcil  1 , Duygu Ege  1 , Kezban Şeker Yaşar  1
Affiliations
Observational Study

Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients

Yunus Emre Özlüer et al. Turk J Med Sci. .

Abstract

Background/aim: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures.

Materials and methods: This retrospective and observational study included eight patients who received ECMO from January 2018 to January 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMO net scores, the management process, and patient outcomes. Blood gas analyses done after the first hour of ECMO initiation and the reevaluation of the patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores in the 24th hour of ECMO were recorded.

Results: The mean age was 52.7 ± 14.2 years. The median duration of the ECMO run was 81 (min–max: 4–267) h, and the mean length of CCU stay was 10.2 ± 6.7 days. Of the 8 patients studied, 5 (62.5%) had veno-arterial and 3 (37.5%) had veno-venous ECMO. Three patients were successfully weaned (37.5%). The overall survival-to-discharge rate was 25%. Carbon dioxide levels were significantly decreased 1 h after ECMO initiation (P = 0.038) as well as the need for vasopressors. Lactate levels were lower in decannulated patients. Changes in the APACHE II score were more consistent with the clinical deterioration in patients than SOFA score changes were.

Conclusions: In the early phase of ECMO, vital signs improve, and the need for vasopressors and carbon dioxide levels decrease. Thus, CCUs in Emergency Departments with ECMO capabilities could potentially be designed, and emergency department ECMO algorithms could be tailored for critically ill patients in addition to out-of-hospital cardiac arrest patients.

Keywords: Extracorporeal membrane oxygenation; cardiac arrest; critical care; emergency department; resuscitation.

PubMed Disclaimer

Conflict of interest statement

The authors of this manuscript declare that there are no conflicts of interest that may have influenced either the conduct or the presentation of the research. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors, and it has not previously been presented at any meeting or an organization.

References

    1. Napp LC Kühn C Bauersachs J. ECMO in cardiac arrest and cardiogenic shock. Herz . 2017;42:27–44. - PMC - PubMed
    1. Bartlett RH Esperanza: presidential address. Transactions of American Society for Artificial Internal Organs . 1985;31:723–726. - PubMed
    1. Sun T Guy A Sidhu A Finlayson G Grunau B Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for emergency cardiac support. Journal of Critical Care . 2018;44:31–38. - PubMed
    1. Oxygenation (ANZ ECMO) Influenza Investigators Davies A Jones D Bailey M Beca J Bellomo R Extracorporeal membrane oxygenation for 2009 influenza A (H1N1) acute respiratory distress syndrome. Journal of the American Medical Association . 2009;302:1888–1895. - PubMed
    1. American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation . 2015;132:316–589. - PubMed

Publication types

LinkOut - more resources