2016
DOI: 10.1097/sla.0000000000001176
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Abstract: Prolonged ECMO use for adult respiratory failure was associated with a lower (45.4%) hospital survival rate, compared with prior reported survival rates of short duration ECMO. Prolonged ECMO survival significantly increased in recent years, and increasing ECMO duration did not alter the survival fraction in the 1989 to 2013 study cohort. Although P-ECMO survival rates are less than short ECMO runs, P-ECMO support is justified.

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Cited by 70 publications
(58 citation statements)
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“…After three weeks 96% of patients have been weaned successfully or have died, and analysis of data on this “tail” of patients on long-term VA ECMO did not suggest positive or negative correlation between treatment duration and survival. This is similar to a recent analysis from the ELSO registry of the survival fraction in prolonged VV ECMO therapy [16]. This may be due to a balance between increased risk with cumulative exposure to the risks of disease progression and treatment complications (for instance intracranial haemorrhage [17] or infection [10]), and the selection of patients perceived to be more likely to survive for longer treatment.…”
Section: Discussionsupporting
confidence: 82%
“…After three weeks 96% of patients have been weaned successfully or have died, and analysis of data on this “tail” of patients on long-term VA ECMO did not suggest positive or negative correlation between treatment duration and survival. This is similar to a recent analysis from the ELSO registry of the survival fraction in prolonged VV ECMO therapy [16]. This may be due to a balance between increased risk with cumulative exposure to the risks of disease progression and treatment complications (for instance intracranial haemorrhage [17] or infection [10]), and the selection of patients perceived to be more likely to survive for longer treatment.…”
Section: Discussionsupporting
confidence: 82%
“…3,7 Further, studies have shown that prolonged ECMO is associated with a 45% hospital survival rate. 8 As per ELSO guidelines, VV-ECMO should be instituted for respiratory failure in early phase of ARDS when lung damage is considered reversible and should be avoided in case of more than 7 days of mechanical ventilation, [9][10][11] but it is difficult to follow this recommendation rigidly and therefore some deviations are often seen. The reason for this is multifactorial -the varied progression of ARDS pathology, late patient referral, late arrival in the tertiary care hospital and the socioeconomic obstacles.…”
Section: Discussionmentioning
confidence: 99%
“…Outcomes in the unique subset of patient requiring the prolonged use of ECMO prior to lung transplantation have in recent years become the subject of study. For example, in a 2016 review of 974 patients who required prolonged (>14 days) ECMO in the Extracorporeal Life Support Organization international multiinstitutional registry, 46% of these patients did not sustain native lung recovery; among these, 40 patients (4.1%) underwent lung transplant with a 50% postoperative in-hospital mortality [30]. While 14 days appears to be the consensus after which ECMO is considered to be prolonged, the upper bounds for the length of time for which ECMO can be continued as a bridging method continue to be tested.…”
Section: Prolonged Bridging With Ecmomentioning
confidence: 99%