PMID- 28525416
OWN - NLM
STAT- MEDLINE
DCOM- 20180406
LR  - 20201209
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 63
IP  - 5
DP  - 2017 Sep/Oct
TI  - Is There a Preinterventional Mechanical Ventilation Time Limit for Candidates of 
      Adult Respiratory Extracorporeal Membrane Oxygenation.
PG  - 650-658
LID - 10.1097/MAT.0000000000000577 [doi]
AB  - Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support 
      in severe acute respiratory distress syndrome (ARDS). Although prolonged 
      mechanical ventilation (MV) before institution of ECMO is known to be a poor 
      prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period 
      has not been defined yet. To discover the answer, we reviewed a 9 year 
      institutional experience of adult respiratory ECMO in VV configuration and 
      investigate the relationship between the MV time before ECMO and in-hospital 
      mortality. This retrospective study included 129 adult patients receiving VV-ECMO 
      for ARDS in a single institution from 2007 to 2016. Important demographic and 
      clinical data before ECMO intervention were collected for analyses of in-hospital 
      mortality. The MV time before ECMO independently predicted hospital death in 
      adult respiratory ECMO here. While compared to the patients receiving MV for 7 
      days or less, the patients receiving MV for more than 7 days before ECMO showed a 
      higher in-hospital mortality rate (77% vs. 38%, p < 0.001). They also experienced 
      a more significant deterioration in respiratory function during MV before the 
      institution of ECMO. Therefore, from the clinical observation, we thought that a 
      7 day period might be an acceptable limit on MV time before institution of 
      VV-ECMO. Integrating other respiratory parameters into the current PaO2/FiO2 (PF) 
      ratio-based inclusion criteria of adult respiratory ECMO might be helpful to 
      reduce the risk of prolonged MV in selected patients.
FAU - Wu, Meng-Yu
AU  - Wu MY
AD  - From the *Department of Cardiovascular Surgery, Chang Gung Memorial Hospital and 
      Chang Gung University, Taoyuan, Taiwan; daggerDepartment of Thoracic Medicine, Chang 
      Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; double daggerDepartment of 
      Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei 
      Medical University, Taipei, Taiwan; and  section signDepartment of Obstetrics and Gynecology, 
      Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
FAU - Huang, Chung-Chi
AU  - Huang CC
FAU - Wu, Tzu-I
AU  - Wu TI
FAU - Chang, Yu-Sheng
AU  - Chang YS
FAU - Wang, Chin-Liang
AU  - Wang CL
FAU - Lin, Pyng-Jing
AU  - Lin PJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
CIN - ASAIO J. 2017 Sep/Oct;63(5):523. PMID: 28799952
MH  - Adult
MH  - Aged
MH  - *Extracorporeal Membrane Oxygenation/mortality
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Respiration
MH  - *Respiration, Artificial
MH  - Respiratory Distress Syndrome/mortality/*therapy
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2017/05/20 06:00
MHDA- 2018/04/07 06:00
CRDT- 2017/05/20 06:00
PHST- 2017/05/20 06:00 [pubmed]
PHST- 2018/04/07 06:00 [medline]
PHST- 2017/05/20 06:00 [entrez]
AID - 10.1097/MAT.0000000000000577 [doi]
PST - ppublish
SO  - ASAIO J. 2017 Sep/Oct;63(5):650-658. doi: 10.1097/MAT.0000000000000577.