Extracorporeal membrane oxygenation (ECMO) has been proven effective in life support for patients with refractory cardiopulmonary failure. Deteriorating patients who have removed their first ECMO support and required second or more courses of ECMO support have rarely been discussed.
All the records of the patients who experienced at least 2 courses of ECMO during single admission were retrieved. Survival was defined as survival to discharge. Demographic data and clinical information were compared between survival and nonsurvival groups. There were 86 patients who received at least 2 courses of ECMO in the 20-year database, and 27 (31.3%) were <18 years old. Of them, 87.3% received 2 runs of ECMO, 10.4% 3 runs, and 2.3% 4 runs. Overall survival rate was 30.2%. The survival rate for patients with 2 runs of ECMO was 33.3% (25 out of 75), 11.1% (1 out of 9) for 3 runs, and 0% (0 out of 2) for 4 runs. Multivariate analysis revealed that only ARF with hemodialysis was the independent risk factor.
The decision to perform repeated ECMO implantation is a complex and difficult process. Despite the arguments debating the consumption of resources and increased complications, there are still nearly 1 out of 3 patients who will survive to discharge. More than 2 courses of ECMO may be carefully considered for further rescue.
Int J Artif Organs 2016; 39(6): 288 - 293
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsHeng-Wen Chou, Te-I Chang, Chih-Hsien Wang, Nai-Kuan Chou, Nai-Hsin Chi, Shu-Chien Huang, I-Hui Wu, Chih-Yang Chan, Lee-Mei Ponge, Ya-Chen Wang, Yih-Sharng Chen
- • Accepted on 27/06/2016
- • Available online on 20/07/2016
- • Published in print on 19/08/2016
This article is available as full text PDF.
- Chou, Heng-Wen [PubMed] [Google Scholar] 1, 2
- Chang, Te-I [PubMed] [Google Scholar] 3, 4
- Wang, Chih-Hsien [PubMed] [Google Scholar] 1
- Chou, Nai-Kuan [PubMed] [Google Scholar] 1
- Chi, Nai-Hsin [PubMed] [Google Scholar] 1
- Huang, Shu-Chien [PubMed] [Google Scholar] 1
- Wu, I-Hui [PubMed] [Google Scholar] 1
- Chan, Chih-Yang [PubMed] [Google Scholar] 1
- Ponge, Lee-Mei [PubMed] [Google Scholar] 1
- Wang, Ya-Chen [PubMed] [Google Scholar] 1
- Chen, Yih-Sharng [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
Division of Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei - Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei - Taiwan
Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei - Taiwan
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei - Taiwan
Heng-Wen Chou and Te-I Chang contributed equally to this study.