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Clinical outcomes of extracorporeal membrane oxygenation in acute traumatic lung injury: a retrospective study.
- Source :
-
Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2020 May 24; Vol. 28 (1), pp. 41. Date of Electronic Publication: 2020 May 24. - Publication Year :
- 2020
-
Abstract
- Background: Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respiratory distress syndrome (ARDS) have a high risk of bleeding during this procedure. This study aimed to determine the safety and feasibility of ECMO in patients with traumatic ARDS.<br />Methods: We retrospectively reviewed medical records and investigated the clinical outcomes of ECMO in 42 patients with traumatic ARDS, among whom near-drowning (42.9%) was the most frequent cause of injury.<br />Results: Thirty-four of 42 patients (81%) survived and were discharged after a median hospital stay of 23 days. A multivariate analysis identified a lactate level (odds ratio: 1.493, 95% confidence interval: 1.060-2.103, P = 0.022) and veno-venous (VV) ECMO (odds ratio: 0.075, 95% confidence interval: 0.006-0.901, P = 0.041) as favorable independent predictors of survival in patients with traumatic ARDS who underwent ECMO. The optimal cut off value for pre-ECMO lactate level was 10.5 mmol/L (area under the curve = 0.929, P = 0.001). In Kaplan-Meier analysis, the survival rate at hospital discharge was significant higher among the patients with a pre-ECMO lactate level of 10.5 mmol/L or less compared with patients with pre-ECMO lactate level greater than 10.5 mmol/L (93.8% versus 40.0%, respectively; P = 0.01).<br />Conclusions: ECMO yielded excellent survival outcomes, particularly in patients with low pre-treatment lactate levels who received VV ECMO. Therefore, ECMO appears safe and highly feasible in a carefully selected population of trauma patients.
- Subjects :
- Acute Lung Injury complications
Acute Lung Injury mortality
Adolescent
Adult
Female
Humans
Length of Stay
Male
Middle Aged
Multivariate Analysis
Patient Discharge
Respiratory Distress Syndrome etiology
Respiratory Distress Syndrome mortality
Retrospective Studies
Survival Rate
Treatment Outcome
Young Adult
Acute Lung Injury therapy
Extracorporeal Membrane Oxygenation
Respiratory Distress Syndrome therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1757-7241
- Volume :
- 28
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scandinavian journal of trauma, resuscitation and emergency medicine
- Publication Type :
- Academic Journal
- Accession number :
- 32448260
- Full Text :
- https://doi.org/10.1186/s13049-020-00733-w