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Outcome of veno-venous extracorporeal membrane oxygenation use in acute respiratory distress syndrome after cardiac surgery with cardiopulmonary bypass

Authors
 Joo Han Song  ;  Won Ki Woo  ;  Seung Hwan Song  ;  Hyo Hyun Kim  ;  Bong Joon Kim  ;  Ha Eun Kim  ;  Do Jung Kim  ;  Jee Won Suh  ;  Yu Rim Shin  ;  Han Ki Park  ;  Seung Hyun Lee  ;  Hyun Chel Joo  ;  Sak Lee  ;  Byung Chul Chang  ;  Kyung Jong Yoo  ;  Young Sam Kim  ;  Young Nam Youn 
Citation
 Journal of Thoracic Disease, Vol.8(7) : 1804-1813, 2016 
Journal Title
 Journal of Thoracic Disease 
ISSN
 2072-1439 
Issue Date
2016
Keywords
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) ; acute respiratory distress syndrome (ARDS) ; cardiac surgery
Abstract
BACKGROUND: Cardiac surgery with cardiopulmonary bypass (CPB) is a known risk factor for acute respiratory distress syndrome (ARDS). We aimed to analyze the treatment outcome in patients who required veno-venous extracorporeal membrane oxygenation (VV-ECMO) for postcardiotomy ARDS despite other rescue modalities. METHODS: We retrospectively reviewed the outcomes in 13 patients (mean age, 54.7±5.9 years) who received VV-ECMO support for refractory ARDS after cardiac surgery between March 2013 and February 2016 at Severance Hospital, Yonsei University (Seoul, Korea). RESULTS: At the start of VV-ECMO, the average lung injury score was 3.0±0.2, and the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score was -4±1.1. Although 7 patients initiated VV-ECMO support within 24 h from operation, the remaining 6 started at a median of 8.5 days (range, 5-16 days). Nine (69.3%) patients were successfully weaned from VV-ECMO. After a median follow-up duration of 14.5 months (range, 1.0-33.0 months) for survivors, the 1-year overall survival was 58.6%±14.4%. The differences in the overall survival from VV-ECMO according to the RESP score risk classes were borderline significant (100% in class III, 50%±25% in class IV, and 20%±17.9% in class V; P=0.088). CONCLUSIONS: VV-ECMO support can be a feasible rescue strategy for adult patients who develop refractory ARDS after a cardiac surgery. Additionally, the RESP score seems a valuable prognostic tool for post-ECMO survival outcome in this patient population as well.
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DOI
10.21037/jtd.2016.05.86
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김도정(Kim, Do Jung)
김봉준(Kim, Bong Joon)
김영삼(Kim, Young Sam) ORCID logo https://orcid.org/0000-0001-9656-8482
김효현(Kim, Hyohyun)
박한기(Park, Han Ki) ORCID logo https://orcid.org/0000-0002-7472-7822
서지원(Suh, Jee Won) ORCID logo https://orcid.org/0000-0003-0287-0651
송승환(Song, Seung Hwan)
송주한(Song, Joo Han)
신유림(Shin, Yu Rim)
우원기(Woo, Won Ki)
유경종(Yoo, Kyung Jong) ORCID logo https://orcid.org/0000-0002-9858-140X
윤영남(Youn, Young Nam)
이삭(Lee, Sak) ORCID logo https://orcid.org/0000-0001-6130-2342
이승현(Lee, Seung Hyun) ORCID logo https://orcid.org/0000-0002-0311-6565
장병철(Chang, Byung Chul)
주현철(Joo, Hyun Chel) ORCID logo https://orcid.org/0000-0002-6842-2942
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152387
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