Long-term venovenous extracorporeal membrane oxygenation support for acute respiratory distress syndrome

Zachary N. Kon, Siamak Dahi, Charles F. Evans, Kimberly A. Byrnes, Gregory J. Bittle, Brody Wehman, Raymond P. Rector, Brian M. McCormick, Daniel L. Herr, Pablo G. Sanchez, Si M. Pham, Bartley P. Griffith

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Background Given substantial advances in venovenous extracorporeal membrane oxygenation (ECMO) technology, long-term support is increasingly feasible. Although the benefits of short-term ECMO as a bridge to recovery in acute respiratory distress syndrome (ARDS) are well described, the utility and outcomes of long-term support remain unclear. Methods Patients requiring ECMO for ARDS between January 2009 and November 2012 were retrospectively reviewed and analyzed separately for those requiring ECMO support for less than 3 weeks or for 3 weeks or longer. Demographic factors, ECMO variables, and outcomes were assessed. Results Fifty-five patients with ARDS received ECMO during the study period, with 11 patients requiring long-term ECMO support and a median duration of 36 (interquartile range: 24 to 68) days. Recovery was the initial goal in all patients. Pre-ECMO mechanical ventilatory support, indices of disease severity, and the ECMO cannulation strategy were similar between the two groups. Eight (73%) patients receiving long-term support were bridged to recovery, and 1 patient was bridged to transplantation after a refractory course. Eight (73%) patients receiving long-term support and 25 (57%) patients receiving short-term support survived to 30 days and hospital discharge. Conclusions Previously, long-term ECMO support was thought to be associated with unfavorable outcomes. This study, however, may provide support for the efficacy of ECMO support even for 3 weeks or more as a bridge to recovery or transplantation.

Original languageEnglish (US)
Pages (from-to)2059-2063
Number of pages5
JournalAnnals of Thoracic Surgery
Volume100
Issue number6
DOIs
StatePublished - 2015

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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