Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients
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 rat...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | Critical Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13054-018-2293-5 |
| _version_ | 1818519146259808256 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Moon Seong Baek |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T01:19:58Z |
| format | Article |
| id | doaj.art-d01e62aaf8d84146953e22704d726f64 |
| institution | Directory Open Access Journal |
| issn | 1364-8535 |
| language | English |
| last_indexed | 2024-12-11T01:19:58Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Critical Care |
| spelling | doaj.art-d01e62aaf8d84146953e22704d726f642022-12-22T01:25:45ZengBMCCritical Care1364-85352019-01-012311910.1186/s13054-018-2293-5Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patientsMoon Seong Baek0Sang-Min Lee1Chi Ryang Chung2Woo Hyun Cho3Young-Jae Cho4Sunghoon Park5So-My Koo6Jae-Seung Jung7Seung Yong Park8Youjin Chang9Byung Ju Kang10Jung-Hyun Kim11Jin Young Oh12So Hee Park13Jung-Wan Yoo14Yun Su Sim15Sang-Bum Hong16Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of MedicineDepartment of Critical Care Medicine, Samsung Medical CenterDepartment of Internal Medicine, Pusan National University Yangsan HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang HospitalDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart HospitalDivision of Pulmonary and Allergy Medicine, Department of Internal Medicine, Soonchunhyang University HospitalDepartment of Thoracic and Cardiovascular Surgery, Anam Hospital, Korea University College of MedicineDepartment of Internal Medicine, Chonbuk National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University College of Medicine, Sanggye Paik HospitalDivision of Pulmonology, Department of Internal Medicine, Ulsan University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Bundang CHA HospitalDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University, Ilsan HospitalDepartment of Pulmonary and Critical Care Medicine, Kyung Hee University HospitalDepartment of Internal Medicine, College of Medicine, Gyeongsang National University HospitalDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Hallym University Kangnam Sacred Heart HospitalDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineAbstract 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.http://link.springer.com/article/10.1186/s13054-018-2293-5Extracorporeal membrane oxygenationUtilizationSurvival |
| spellingShingle | 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 Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients Critical Care Extracorporeal membrane oxygenation Utilization Survival |
| title | Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients |
| title_full | Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients |
| title_fullStr | Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients |
| title_full_unstemmed | Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients |
| title_short | Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients |
| title_sort | improvement in the survival rates of extracorporeal membrane oxygenation supported respiratory failure patients a multicenter retrospective study in korean patients |
| topic | Extracorporeal membrane oxygenation Utilization Survival |
| url | http://link.springer.com/article/10.1186/s13054-018-2293-5 |
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