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Critical Care
Published in: Critical Care 1/2019

Open Access 01-12-2019 | Acute Respiratory Distress-Syndrome | Research

Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients

Authors: Moon Seong Baek, Sang-Min Lee, Chi Ryang Chung, Woo Hyun Cho, Young-Jae Cho, Sunghoon Park, So-My Koo, Jae-Seung Jung, Seung Yong Park, Youjin Chang, Byung Ju Kang, Jung-Hyun Kim, Jin Young Oh, So Hee Park, Jung-Wan Yoo, Yun Su Sim, Sang-Bum Hong

Published in: Critical Care | Issue 1/2019

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Abstract

Background

Although the utilization of extracorporeal membrane oxygenation (ECMO) is increasing and its technology is evolving, only a few epidemiologic reports have described the uses and outcomes of ECMO. The aim of this study was to investigate the changes in utilization and survival rate in patients supported with ECMO for severe respiratory failure in Korea.

Methods

This was a multicenter study on consecutive patients who underwent ECMO across 16 hospitals in Korea. The records of all patients who required ECMO for acute respiratory failure between 2012 and 2015 were retrospectively reviewed, and the utilization of ECMO was analyzed over time.

Results

During the study period, 5552 patients received ECMO in Korea as a whole, and a total of 2472 patients received ECMO at the participating 16 hospitals. We analyzed 487 (19.7%) patients who received ECMO for respiratory failure. The number of ECMO procedures provided for respiratory failure increased from 104 to 153 during the study period. The in-hospital survival rate increased from 30.8% to 35.9%. The use of prone positioning increased from 6.8% to 49.0% (p < 0.001), and the use of neuromuscular blockers also increased from 28.2% to 58.2% (p < 0.001). Multiple regression analysis showed that old age (OR 1.038 (95% CI 1.022, 1.054)), use of corticosteroid (OR 2.251 (95% CI 1.153, 4.397)), continuous renal replacement therapy (OR 2.196 (95% CI 1.135, 4.247)), driving pressure (OR 1.072 (95% CI 1.031, 1.114)), and prolonged ECMO duration (OR 1.020 (95% CI 1.003, 1.038)) were associated with increased odds of mortality.

Conclusions

Utilization of ECMO and survival rates of patients who received ECMO for respiratory failure increased over time in Korea. The use of pre-ECMO prone positioning and neuromuscular blockers also increased during the same period.
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Metadata
Title
Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients
Authors
Moon Seong Baek
Sang-Min Lee
Chi Ryang Chung
Woo Hyun Cho
Young-Jae Cho
Sunghoon Park
So-My Koo
Jae-Seung Jung
Seung Yong Park
Youjin Chang
Byung Ju Kang
Jung-Hyun Kim
Jin Young Oh
So Hee Park
Jung-Wan Yoo
Yun Su Sim
Sang-Bum Hong
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2019
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-018-2293-5

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