Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study
Objective To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010. Methods This retrospective co...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-06-01
|
| Series: | Journal of International Medical Research |
| Online Access: | https://doi.org/10.1177/0300060520935704 |
| _version_ | 1819031637796585472 |
|---|---|
| author | Surat Tongyoo Chairat Permpikul Siwalai Sucher Preecha Thomrongpairoj Akekarin Poompichet Ranistha Ratanarat Nitipatana Chierakul |
| author_facet | Surat Tongyoo Chairat Permpikul Siwalai Sucher Preecha Thomrongpairoj Akekarin Poompichet Ranistha Ratanarat Nitipatana Chierakul |
| author_sort | Surat Tongyoo |
| collection | DOAJ |
| description | Objective To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010. Methods This retrospective cohort study enrolled adults with severe ARDS (PaO 2 /FiO 2 ratio of <100 with FiO 2 of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. The primary outcome was hospital mortality. Results Sixty-four patients (ECMO, n = 30; mechanical ventilation, n = 34) were recruited. There was no significant difference in the baseline PaO 2 /FiO 2 ratio (67.2 ± 25.7 vs. 76.6 ± 16.0), FiO 2 (97 ± 9 vs. 94 ± 8), or Murray score (3.4 ± 0.5 vs. 3.3 ± 0.5) between the ECMO and mechanical ventilation groups. The hospital mortality rate was also not significantly different between the two groups (ECMO, 20/30 [66.7%] vs. mechanical ventilation, 24/34 [70.6%]). Patients who underwent ECMO were ventilated with a significantly lower TV than patients who underwent mechanical ventilation (3.8 ± 1.8 vs. 6.6 ± 1.4 mL, respectively). Conclusion Although VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT 04031794). |
| first_indexed | 2024-12-21T06:49:13Z |
| format | Article |
| id | doaj.art-0ec3ac28f91d409abc7f9ff799d0f645 |
| institution | Directory Open Access Journal |
| issn | 1473-2300 |
| language | English |
| last_indexed | 2024-12-21T06:49:13Z |
| publishDate | 2020-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of International Medical Research |
| spelling | doaj.art-0ec3ac28f91d409abc7f9ff799d0f6452022-12-21T19:12:31ZengSAGE PublishingJournal of International Medical Research1473-23002020-06-014810.1177/0300060520935704Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort studySurat TongyooChairat PermpikulSiwalai SucherPreecha ThomrongpairojAkekarin PoompichetRanistha RatanaratNitipatana ChierakulObjective To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010. Methods This retrospective cohort study enrolled adults with severe ARDS (PaO 2 /FiO 2 ratio of <100 with FiO 2 of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. The primary outcome was hospital mortality. Results Sixty-four patients (ECMO, n = 30; mechanical ventilation, n = 34) were recruited. There was no significant difference in the baseline PaO 2 /FiO 2 ratio (67.2 ± 25.7 vs. 76.6 ± 16.0), FiO 2 (97 ± 9 vs. 94 ± 8), or Murray score (3.4 ± 0.5 vs. 3.3 ± 0.5) between the ECMO and mechanical ventilation groups. The hospital mortality rate was also not significantly different between the two groups (ECMO, 20/30 [66.7%] vs. mechanical ventilation, 24/34 [70.6%]). Patients who underwent ECMO were ventilated with a significantly lower TV than patients who underwent mechanical ventilation (3.8 ± 1.8 vs. 6.6 ± 1.4 mL, respectively). Conclusion Although VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT 04031794).https://doi.org/10.1177/0300060520935704 |
| spellingShingle | Surat Tongyoo Chairat Permpikul Siwalai Sucher Preecha Thomrongpairoj Akekarin Poompichet Ranistha Ratanarat Nitipatana Chierakul Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study Journal of International Medical Research |
| title | Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study |
| title_full | Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study |
| title_fullStr | Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study |
| title_full_unstemmed | Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study |
| title_short | Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study |
| title_sort | venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome a retrospective cohort study |
| url | https://doi.org/10.1177/0300060520935704 |
| work_keys_str_mv | AT surattongyoo venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT chairatpermpikul venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT siwalaisucher venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT preechathomrongpairoj venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT akekarinpoompichet venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT ranistharatanarat venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy AT nitipatanachierakul venovenousextracorporealmembraneoxygenationversusconventionalmechanicalventilationtotreatrefractoryhypoxemiainpatientswithacuterespiratorydistresssyndromearetrospectivecohortstudy |