Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation
Abstract Background The use of extracorporeal membrane oxygenation (ECMO) in awake, spontaneously breathing and non-intubated patients (awake ECMO) may be a novel therapeutic strategy for severe acute respiratory distress syndrome (ARDS) patients. The purpose of this study is to assess the feasibili...
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-019-1016-2 |
| _version_ | 1818661605352669184 |
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| author | Jingen Xia Sichao Gu Min Li Donglin Liu Xu Huang Li Yi Lijuan Wu Guohui Fan Qingyuan Zhan |
| author_facet | Jingen Xia Sichao Gu Min Li Donglin Liu Xu Huang Li Yi Lijuan Wu Guohui Fan Qingyuan Zhan |
| author_sort | Jingen Xia |
| collection | DOAJ |
| description | Abstract Background The use of extracorporeal membrane oxygenation (ECMO) in awake, spontaneously breathing and non-intubated patients (awake ECMO) may be a novel therapeutic strategy for severe acute respiratory distress syndrome (ARDS) patients. The purpose of this study is to assess the feasibility and safety of awake ECMO in severe ARDS patients receiving prolonged ECMO (> 14 days). Methods We describe our experience with 12 consecutive severe ARDS patients (age, 39.1 ± 16.4 years) supported with awake ECMO to wait for native lung recovery during prolonged ECMO treatment from July 2013 to January 2018. Outcomes are reported including the hospital mortality, ECMO-related complications and physiological data on weaning from invasive ventilation. Results The patients received median 26.0 (15.5, 64.8) days of total ECMO duration in the cohort. The longest ECMO support duration was 121 days. Awake ECMO and extubation was implemented after median 10.2(5.0, 42.9) days of ECMO. Awake ECMO was not associated with increased morbidity. The total invasive ventilation duration, lengths of stay in the ICU and hospital in the cohort were 14.0(12.0, 37.3) days, 33.0(22.3, 56.5) days and 46.5(27.3, 84.8) days, respectively. The hospital mortality rate was 33.3% (4/12) in the cohort. Survivors had more stable respiratory rate and heart rate after extubation when compared to the non-survivors. Conclusions With carefully selected patients, awake ECMO is a feasible and safe strategy for severe pulmonary ARDS patients receiving prolonged ECMO support to wait for native lung recovery. |
| first_indexed | 2024-12-17T04:47:43Z |
| format | Article |
| id | doaj.art-6e9cf088b47b4c01b8b4c2b934197de6 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-17T04:47:43Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-6e9cf088b47b4c01b8b4c2b934197de62022-12-21T22:03:01ZengBMCBMC Pulmonary Medicine1471-24662019-12-011911810.1186/s12890-019-1016-2Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenationJingen Xia0Sichao Gu1Min Li2Donglin Liu3Xu Huang4Li Yi5Lijuan Wu6Guohui Fan7Qingyuan Zhan8National Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalCapital Medical UniversityNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalInstitute of Clinical Medical Sciences, China-Japan Friendship HospitalNational Clinical Research Center for Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship HospitalAbstract Background The use of extracorporeal membrane oxygenation (ECMO) in awake, spontaneously breathing and non-intubated patients (awake ECMO) may be a novel therapeutic strategy for severe acute respiratory distress syndrome (ARDS) patients. The purpose of this study is to assess the feasibility and safety of awake ECMO in severe ARDS patients receiving prolonged ECMO (> 14 days). Methods We describe our experience with 12 consecutive severe ARDS patients (age, 39.1 ± 16.4 years) supported with awake ECMO to wait for native lung recovery during prolonged ECMO treatment from July 2013 to January 2018. Outcomes are reported including the hospital mortality, ECMO-related complications and physiological data on weaning from invasive ventilation. Results The patients received median 26.0 (15.5, 64.8) days of total ECMO duration in the cohort. The longest ECMO support duration was 121 days. Awake ECMO and extubation was implemented after median 10.2(5.0, 42.9) days of ECMO. Awake ECMO was not associated with increased morbidity. The total invasive ventilation duration, lengths of stay in the ICU and hospital in the cohort were 14.0(12.0, 37.3) days, 33.0(22.3, 56.5) days and 46.5(27.3, 84.8) days, respectively. The hospital mortality rate was 33.3% (4/12) in the cohort. Survivors had more stable respiratory rate and heart rate after extubation when compared to the non-survivors. Conclusions With carefully selected patients, awake ECMO is a feasible and safe strategy for severe pulmonary ARDS patients receiving prolonged ECMO support to wait for native lung recovery.https://doi.org/10.1186/s12890-019-1016-2Extracorporeal membrane oxygenationAcute respiratory distress syndromeSpontaneous breathingMechanical ventilation |
| spellingShingle | Jingen Xia Sichao Gu Min Li Donglin Liu Xu Huang Li Yi Lijuan Wu Guohui Fan Qingyuan Zhan Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation BMC Pulmonary Medicine Extracorporeal membrane oxygenation Acute respiratory distress syndrome Spontaneous breathing Mechanical ventilation |
| title | Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| title_full | Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| title_fullStr | Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| title_full_unstemmed | Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| title_short | Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| title_sort | spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation |
| topic | Extracorporeal membrane oxygenation Acute respiratory distress syndrome Spontaneous breathing Mechanical ventilation |
| url | https://doi.org/10.1186/s12890-019-1016-2 |
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