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Cumulative Fluid Balance during Extracorporeal Membrane Oxygenation and Mortality in Patients with Acute Respiratory Distress Syndrome
- Source :
- Membranes, Vol 11, Iss 567, p 567 (2021), Membranes, Volume 11, Issue 8
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Extracorporeal membrane oxygenation (ECMO) is considered a salvage therapy in cases of severe acute respiratory distress syndrome (ARDS) with profound hypoxemia. However, the need for high-volume fluid resuscitation and blood transfusions after ECMO initiation introduces a risk of fluid overload. Positive fluid balance is associated with mortality in critically ill patients, and conservative fluid management for ARDS patients has been shown to shorten both the duration of mechanical ventilation and time spent in intensive care, albeit without a significant effect on survival. Nonetheless, few studies have addressed the influence of fluid balance on clinical outcomes in severe ARDS patients undergoing ECMO. In the current retrospective study, we examined the impact of cumulative fluid balance (CFB) on hospital mortality in 152 cases of severe ARDS treated using ECMO. Overall hospital mortality was 53.3%, and we observed a stepwise positive correlation between CFB and the risk of death. Cox regression models revealed that CFB during the first 3 days of ECMO was independently associated with higher hospital mortality (adjusted hazard ratio 1.110 [95% CI 1.027–1.201]<br />p = 0.009). Our findings indicate the benefits of a conservative treatment approach to avoid fluid overload during the early phase of ECMO when dealing with severe ARDS patients.
- Subjects :
- Resuscitation
ARDS
medicine.medical_treatment
Filtration and Separation
TP1-1185
Article
Hypoxemia
03 medical and health sciences
0302 clinical medicine
Chemical engineering
Intensive care
medicine
Extracorporeal membrane oxygenation
Chemical Engineering (miscellaneous)
cumulative fluid balance
Mechanical ventilation
business.industry
Process Chemistry and Technology
Chemical technology
Hazard ratio
030208 emergency & critical care medicine
Retrospective cohort study
acute respiratory distress syndrome
extracorporeal membrane oxygenation
medicine.disease
mortality
surgical procedures, operative
030228 respiratory system
Anesthesia
TP155-156
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 20770375
- Volume :
- 11
- Issue :
- 567
- Database :
- OpenAIRE
- Journal :
- Membranes
- Accession number :
- edsair.doi.dedup.....d0e8aec3213cc9c36db2245ea36360b3