Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-01-03

AUTHORS

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

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. More... »

PAGES

1

Journal

TITLE

Critical Care

ISSUE

1

VOLUME

23

Author Affiliations

  • Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
  • Department of Critical Care Medicine, Samsung Medical Center, Seoul, Republic of Korea
  • Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do Republic of Korea
  • Division of Pulmonary and Allergy Medicine, Department of Internal Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea
  • Department of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
  • Department of Internal Medicine, Chonbuk National University Hospital, Jeonju-si, Jeollabuk-do Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Republic of Korea
  • Division of Pulmonology, Department of Internal Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bundang CHA Hospital, Seongnam-si, Gyeonggi-do Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University, Ilsan Hospital, Goyang-si, Gyeonggi-do Republic of Korea
  • Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital, Gangdong, Seoul, Republic of Korea
  • Department of Internal Medicine, College of Medicine, Gyeongsang National University Hospital, Jinju, Gyeonsangnam-do Republic of Korea
  • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13054-018-2293-5

    DOI

    http://dx.doi.org/10.1186/s13054-018-2293-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111097120

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30606235


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