Extracorporeal membrane oxygenation: experience in an adult medical ICU

Thorac Cardiovasc Surg. 2007 Jun;55(4):223-8. doi: 10.1055/s-2006-955942.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) is a technology that can provide extracorporeal gas exchange to patients with severe pulmonary or cardiac dysfunction. We report on our clinical experience with ECMO in critically ill patients.

Methods: We performed a retrospective analysis of 23 patients treated with ECMO in a medical intensive care unit in a tertiary referral academic centre.

Results: 13 patients were considered immunocompetent and 10 were immunocompromised when extracorporeal membrane oxygenation was started. 16 patients presented with acute respiratory distress syndrome (ARDS), 2 patients had intractable cardiac failure, and 5 patients had combined respiratory and cardiac failure. In 16 patients, a veno-venous bypass was constructed; in 7 patients, the initial bypass was venoarterial. 11 patients survived. In 2 patients technical complications were fatal.

Conclusions: Our data indicate that patients with community-acquired pneumonia and no underlying disease will benefit most from this technique. However, long-term survival is possible in immunocompromised patients. Venoarterial bypass can carry a higher risk for technical complications. Increasing experience apparently also reduces the risk of technical complications.

MeSH terms

  • Adult
  • Aged
  • Cause of Death
  • Community-Acquired Infections / complications
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Female
  • Heart Failure / therapy*
  • Humans
  • Immunocompetence
  • Immunocompromised Host
  • Intensive Care Units
  • Male
  • Middle Aged
  • Oxygen / blood
  • Pneumonia / complications
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / therapy*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Oxygen