Prognostic Factors for Adult Patients Receiving Extracorporeal Membrane Oxygenation as Mechanical Circulatory Support-A 14-Year Experience at a Medical Center

Extracorporeal membrane oxygenation (ECMO) is a resource‐consuming and highly invasive treatment. There were 1100 ECMO cases at the National Taiwan University Hospital between August 1994 and November 2008. Of these, 607 were adults (>18 years old) who received ECMO as mechanical circulatory supp...

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Bibliographic Details
Published in:Artificial organs 2010-02, Vol.34 (2), p.E59-E64
Main Authors: Lan, Chinchun, Tsai, Pi-Ru, Chen, Yih-Sharng, Ko, Wen-Je
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cause of Death
Chi-Square Distribution
Extracorporeal Membrane Oxygenation
Female
Heart Failure - mortality
Heart Failure - therapy
Humans
Male
Mechanical circulatory support
Middle Aged
Patient Selection
Prognosis
Prognostic factor
Regression Analysis
Respiratory Insufficiency - mortality
Respiratory Insufficiency - therapy
Retrospective Studies
Risk Factors
Treatment Outcome
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Summary:Extracorporeal membrane oxygenation (ECMO) is a resource‐consuming and highly invasive treatment. There were 1100 ECMO cases at the National Taiwan University Hospital between August 1994 and November 2008. Of these, 607 were adults (>18 years old) who received ECMO as mechanical circulatory support. In this study, patient characteristics and complications during the ECMO course were evaluated for their correlation with prognosis. The following factors were significantly different between survivors and nonsurvivors: age, coronary artery disease, diabetes mellitus, brain death, stroke during ECMO, the need for dialysis during ECMO, pre‐ECMO infection, hypoglycemia, acidosis, alkalosis, the need for a distal perfusion catheter, and the amount of red blood cells transfused. Six independent predictors of mortality were identified: age, stroke, the need for dialysis during ECMO, pre‐ECMO infection, hypoglycemia, and alkalosis. Our institution has comparatively extensive experience with adult patients, which may be quite different from other medical centers with respect to distribution of patient age. The findings should lead to better utilization of ECMO for adult patients in the future.
ISSN:0160-564X
1525-1594
DOI:10.1111/j.1525-1594.2009.00909.x