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Open Access 01-12-2021 | Vasculitis | Research

Outcomes of severe systemic rheumatic disease patients requiring extracorporeal membrane oxygenation

Authors: Pierre Bay, Guillaume Lebreton, Alexis Mathian, Pierre Demondion, Cyrielle Desnos, Juliette Chommeloux, Guillaume Hékimian, Nicolas Bréchot, Ania Nieszkowska, Matthieu Schmidt, Fleur Cohen-Aubart, Pascal Leprince, Charles-Edouard Luyt, Zahir Amoura, Alain Combes, Marc Pineton de Chambrun

Published in: Annals of Intensive Care | Issue 1/2021

Abstract

Background

Systemic rheumatic diseases (SRDs) are a group of inflammatory disorders that can require intensive care unit (ICU) admission because of multiorgan involvement with end-organ failure(s). Critically ill SRD patients requiring extracorporeal membrane oxygenation (ECMO) were studied to gain insight into their characteristics and outcomes.

Methods

This French monocenter, retrospective study included all SRD patients requiring venovenous (VV)- or venoarterial (VA)-ECMO admitted to a 26-bed ECMO-dedicated ICU from January 2006 to February 2020. The primary endpoint was in-hospital mortality.

Results

Ninety patients (male/female ratio: 0.5; mean age at admission: 41.6 ± 15.2 years) admitted to the ICU received VA/VV-ECMO, respectively, for an SRD-related flare (n = 69, n = 38/31) or infection (n = 21, n = 10/11). SRD was diagnosed in-ICU for 31 (34.4%) patients. In-ICU and in-hospital mortality rates were 48.9 and 51.1%, respectively. Nine patients were bridged to cardiac (n = 5) or lung transplantation (n = 4), or left ventricular assist device (n = 2). The Cox multivariable model retained the following independent predictors of in-hospital mortality: in-ICU SRD diagnosis, day-0 Simplified Acute Physiology Score (SAPS) II score ≥ 70 and arterial lactate ≥ 7.5 mmol/L for VA-ECMO–treated patients; diagnosis other than vasculitis, day-0 SAPS II score ≥ 70, ventilator-associated pneumonia and arterial lactate ≥ 7.5 mmol/L for VV-ECMO–treated patients.

Conclusions

ECMO support is a relevant rescue technique for critically ill SRD patients, with 49% survival at hospital discharge. Vasculitis was independently associated with favorable outcomes of VV-ECMO–treated patients. Further studies are needed to specify the role of ECMO for SRD patients.

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Title: Outcomes of severe systemic rheumatic disease patients requiring extracorporeal membrane oxygenation
Authors: Pierre Bay
Guillaume Lebreton
Alexis Mathian
Pierre Demondion
Cyrielle Desnos
Juliette Chommeloux
Guillaume Hékimian
Nicolas Bréchot
Ania Nieszkowska
Matthieu Schmidt
Fleur Cohen-Aubart
Pascal Leprince
Charles-Edouard Luyt
Zahir Amoura
Alain Combes
Marc Pineton de Chambrun
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Vasculitis
Vasculitis
Cardiogenic Shock
Cardiogenic Shock
Acute Respiratory Distress-Syndrome
ECMO
ECMO
Published in: Annals of Intensive Care / Issue 1/2021
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-021-00819-3

2024 ASCO Annual Meeting

Springer Medicine

Outcomes of severe systemic rheumatic disease patients requiring extracorporeal membrane oxygenation

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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