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Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation

 Nam Eun Kim  ;  Ala Woo  ;  Song Yee Kim  ;  Ah Young Leem  ;  Youngmok Park  ;  Se Hyun Kwak  ;  Seung Hyun Yong  ;  Kyungsoo Chung  ;  Moo Suk Park  ;  Young Sam Kim  ;  Ha Eun Kim  ;  Jin Gu Lee  ;  Hyo Chae Paik  ;  Su Hwan Lee 
 RESPIRATORY RESEARCH, Vol.22(1) : 306, 2021-11 
Journal Title
Issue Date
Critical care ; Extracorporeal membrane oxygenation ; Lung transplantation ; Respiratory function tests
Background: As lung transplantation (LTx) is becoming a standard treatment for end-stage lung disease, the use of bridging with extracorporeal membrane oxygenation (ECMO) is increasing. We examined the clinical impact of being awake during ECMO as bridging therapy in patients awaiting LTx.

Methods: In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019; 64 patients received ECMO support while awaiting LTx. We divided into awake and non-awake groups and compared.

Results: Twenty-five patients (39.1%) were awake, and 39 (61.0%) were non-awake. The median age of awake patients was 59.0 (interquartile range, 52.5-63.0) years, and 80% of the group was men. The awake group had better post-operative outcomes than the non-awake group: statistically shorter post-operative intensive care unit length of stay [awake vs. non-awake, 6 (4-8.5) vs. 18 (11-36), p < 0.001], longer ventilator free days [awake vs. non-awake, 24 (17-26) vs. 0 (0-15), p < 0.001], and higher gait ability after LTx (awake vs. non-awake, 92% vs. 59%, p = 0.004), leading to higher 6-month and 1-year lung function (forced expiratory volume in 1 s: awake vs. non-awake, 6-month, 77.5% vs. 61%, p = 0.004, 1-year, 75% vs. 57%, p = 0.013). Furthermore, the awake group had significantly lower 6-month and 1-year mortality rates than the non-awake group (6-month 12% vs. 38.5%, p = 0.022, 1-year 24% vs. 53.8%, p = 0.018).

Conclusions: In patients with end-stage lung disease, considering the long-term and short-term impacts, the awake ECMO strategy could be useful compared with the non-awake ECMO strategy.
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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
Kwak, Se Hyun(곽세현)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Ha Eun(김하은)
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Youngmok(박영목) ORCID logo https://orcid.org/0000-0002-5669-1491
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Yong, Seung Hyun(용승현)
Woo, Ala(우아라)
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
Lee, Jin Gu(이진구)
Leem, Ah Young(임아영) ORCID logo https://orcid.org/0000-0001-5165-3704
Jung, Kyung Soo(정경수) ORCID logo https://orcid.org/0000-0003-1604-8730
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