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Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation.

Authors
 Kyoung Shik Narm  ;  Seokkee Lee  ;  Jee Won Suh  ;  Anes Kim  ;  Jin Gu Lee  ;  Moo Suk Park  ;  Song Yee Kim  ;  Joo Han Song  ;  Su Jin Jeong  ;  Hyo Chae Paik 
Citation
 Annals of Thoracic Surgery, Vol.105(1) : 242-248, 2018 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2018
MeSH
Adult ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Intraoperative Care/statistics & numerical data* ; Lung Transplantation* ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Withholding Treatment
Abstract
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used for hemodynamic support during lung transplantation (LTx). We evaluated the risk factors associated with failure of weaning from ECMO in the operating room during LTx. METHODS: We retrospectively reviewed 74 consecutive patients who had undergone LTx from March 2013 to February 2016. Patients who underwent single LTx, multiorgan transplantation, and LTx for pulmonary hypertension were excluded. All operations were performed under ECMO support. Clinical data of donor, recipient, and intraoperative parameters were reviewed. RESULTS: Younger donors (40 ± 11 versus 45 ± 10 years, p = 0.047), donors with shorter mechanical ventilation (125 ± 74 versus 160 ± 80 minutes, p = 0.066) and donors with higher Pao2 at 100% oxygen (455 ± 87 mm Hg versus 399 ± 88 mm Hg, p = 0.008) were significantly different in the ECMO weaning group than in the weaning failure group. Of the recipients, the number of patients who had preoperative ECMO support were significantly fewer in the successful weaning group than in the weaning failure group (11.9% versus 34.4%, p = 0.061). The operation time was significantly shorter in the weaning group than in the weaning failure group (392 ± 66 versus 435 ± 82 minutes, p = 0.014). In multivariate logistic regression analysis, the independent risk factors for ECMO weaning were donor age (odds ratio 1.101, 95% confidence interval: 1.030 to 1.177, p = 0.005), donor Pao2 (odds ratio 0.992, 95% confidence interval: 0.984 to 0.999, p = 0.034), and operation time (odds ratio 1.010, 95% confidence interval: 1.000 to 1.019, p = 0.043). CONCLUSIONS: Our results showed that younger donor age, high Pao2, and shorter operation time were factors related to successful ECMO weaning in the operating room after LTx.
Full Text
https://www.sciencedirect.com/science/article/pii/S0003497517310962
DOI
10.1016/j.athoracsur.2017.07.046
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
남경식(Narm, Kyoung Shik)
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
백효채(Paik, Hyo Chae) ORCID logo https://orcid.org/0000-0001-9309-8235
서지원(Suh, Jee Won) ORCID logo https://orcid.org/0000-0003-0287-0651
송주한(Song, Joo Han)
이진구(Lee, Jin Gu)
정수진(Jeong, Su Jin) ORCID logo https://orcid.org/0000-0003-4025-4542
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165479
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