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Kim, Han, Hong, Yoon, Lee, Lee, Hong, Lee, Kim, Lee, and Cho: Acute Respiratory Failure Treated with Veno-venous Extracorporeal Membrane Oxygenation
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(2): 62-66.

Published online: 28 February 2010

DOI: https://doi.org/10.4046/trd.2010.68.2.62

Acute Respiratory Failure Treated with Veno-venous Extracorporeal Membrane Oxygenation

Hyoung Soo Kim, M.D.1, Sang Jin Han, M.D.2, Kyung Soon Hong, M.D.2, Duck Hyoung Yoon, M.D.2, Chang Youl Lee, M.D.3, Myung-Goo Lee, M.D.3, Won Ki Hong, M.D.4, Sun Hee Lee, APN5, Kun Il Kim, M.D.6, Hee-Sung Lee, M.D.7, Sung-Woo Cho, M.D.8

1Department of Thoracic & Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chucheon, Korea.

2Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chucheon, Korea.

3Department of Pulmonology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chucheon, Korea.

4Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chucheon, Korea.

5Advanced Practice Nurse of Thoracic & Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chucheon, Korea.

6Department of Thoracic & Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

7Department of Thoracic & Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

8Department of Thoracic & Cardiovascular Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Address for correspondence: Hyoung Soo Kim, M.D. Department of Thoracic & Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153, Kyo-dong, Chuncheon 200-704, Korea. Phone: 82-33-240-5347, Fax: 82-33-255-6244, cskhs99@hallym.or.kr

Received 18 October 2009       Accepted 11 January 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure.

Methods

From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a PaO2/FiO2 ratio <100 mm Hg on FiO2 of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. EBS®, Bio-pump®, and Centrifugal Rotaflow pump® were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation.

Results

Five of the 7 patients were male and the mean age was 46.3±18.3. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was 17.3±13.7 days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days.

Conclusion

The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.

Keywords: Extracorporeal Membrane Oxygenation, Respiratory Distress Syndrome, Acute

Figures and Tables

Table 1
Pre-ECMO patients data
trd-68-62-i001

ECMO: extracorporeal membrane oxygenation; Pts: patients; post-op: postoperative; ICH: intracranial hemorrhage; d/t: due to; LLL: left lower lobe lobectomy; VATS: video-assisted thoracoscopic surgery.

Table 2
Data on the seven patients with veno-venous ECMO
trd-68-62-i002

BSA: body surface area; pRBC: packed RBC; FFP: fresh frozen plasma; Cryo: cryoprecipitate; PC: platelet concentrate; CRRT: continuous renal replacement therapy; ARF: acute renal failure; Lt: left; MOF: multi-organ failure; SAH: subarachnoid hemorrhage; HD: hospital day.

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