The Outcome of Extracorporeal Life Support After General Thoracic Surgery: Timing of Application

Lee, Heemoon; Cho, Yang Hyun; Chang, Hyoung Woo; Yang, Ji Hyuk; Cho, Jong Ho; Sung, Kiick; Lee, Young Tak

doi:10.1016/j.athoracsur.2017.02.043

Cited by 11 publications

(14 citation statements)

References 20 publications

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“…A more recent retrospective study recorded an incidence of 0.2%, over 8 years, of ECMO placement after general thoracic surgery. Specifically, 29 patients required postoperative extracorporeal life support among 17,185 adults who underwent general thoracic surgical procedures (10). The indications for ECMO were respiratory failure in 82.8% of cases, and hemodynamic instability in 17.2% of cases.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for postoperative complications in general thoracic surgery: a ten years experience of a university referral centre

Gregorio¹,

Sella²,

Ferrigno³

et al. 2020

Curr Chall Thorac Surg

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Background: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy that supports gas exchange and hemodynamic parameters in patients with severe respiratory or cardiac failure. In the last ten years, a significant increment in the use of ECMO has been occurred in thoracic surgery for lung transplant, but little is known about the role of ECMO to face severe complications after general thoracic surgery. This study aims: (I) to investigate the incidence of postoperative adverse events, requiring ECMO support, after general thoracic surgery, and (II) to evaluate the intensive care unit (ICU) and hospital survival in patients who received ECMO after general thoracic surgery. Methods:We retrospectively reviewed the ECMO registry data on patients who received ECMO after general thoracic surgery at

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Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for postoperative complications in general thoracic surgery: a ten years experience of a university referral centre

Gregorio¹,

Sella²,

Ferrigno³

et al. 2020

Curr Chall Thorac Surg

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“…The treatment and prevention of fluid overload and AKI in ECMO patients is typically managed using renal replacement therapy (RRT). Studies show that between 20 and 100% of ECMO patients suffering from AKI are treated with RRT before or during the ECMO treatment ( 11 , 51 , 52 ). CRRT is the most common modality used in the treatment of ECMO patients.…”

Section: Medical Backgroundmentioning

confidence: 99%

Trends, Advantages and Disadvantages in Combined Extracorporeal Lung and Kidney Support From a Technical Point of View

Costa

Halfwerk

Wiegmann

et al. 2022

Front. Med. Technol.

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Extracorporeal membrane oxygenation (ECMO) provides pulmonary and/or cardiac support for critically ill patients. Due to their diseases, they are at high risk of developing acute kidney injury. In that case, continuous renal replacement therapy (CRRT) is applied to provide renal support and fluid management. The ECMO and CRRT circuits can be combined by an integrated or parallel approach. So far, all methods used for combined extracorporeal lung and kidney support present serious drawbacks. This includes not only high risks of circuit related complications such as bleeding, thrombus formation, and hemolysis, but also increase in technical workload and health care costs. In this sense, the development of a novel optimized artificial lung device with integrated renal support could offer important treatment benefits. Therefore, we conducted a review to provide technical background on existing techniques for extracorporeal lung and kidney support and give insight on important aspects to be addressed in the development of this novel highly integrated artificial lung device.

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“…Extensive disease was described as stage III or IV for lymphoma, locally extensive disease for NHMs, a bone marrow blast count of more than 80%, more than 25 000 blasts/µL in peripheral blood, or the need for leukapheresis for HMs. 17,18 In addition, recent malignancy was defined as the diagnostic confirmation of malignancy within 30 days prior to the initiation of ECMO. 13,19 The exclusion criteria were as follows: (a) patients under 18 years of age, (b) patients diagnosed with malignancy, (c) patients who were treated for NHM for more than 1 year prior to the initiation of ECMO, or (d) patients whose data were either lost or missing when they were transferred from other hospitals to our institution after ECMO initiation.…”

Section: Study Design and Populationmentioning

confidence: 99%

Outcomes of extracorporeal membrane oxygenation in adults with active hematologic and nonhematologic malignancy

Park

et al. 2021

Artificial Organs

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Although the number of cancer patients admitted to the intensive care unit is increasing, the data on the use of extracorporeal membrane oxygenation in patients with malignancy are limited. We applied extracorporeal membrane oxygenation to carefully selected patients with active hematologic malignancy or nonhematologic malignancy who experienced respiratory or cardiac failure despite maximal conventional therapy. Patients with active malignancy who underwent extracorporeal membrane oxygenation in our institution between January 2012 and December 2016 were included in this study. The primary outcome of this study was defined as survival to hospital discharge. We also investigated the factors associated with survival to hospital discharge. There were 30 (30.6%) and 68 (69.4%) patients in the hematologic malignancy group and the nonhematologic malignancy group, respectively. Patients in the hematologic malignancy group were younger, more neutropenic, more hypotensive, had a lower Charlson Comorbidity Index, higher sequential organ failure assessment score, and lower platelet count than those in the nonhematologic malignancy group. Forty-six (46.9%) patients were successfully weaned off extracorporeal membrane oxygenation, and 30 (30.6%) patients survived until hospital discharge.Hospital survival rate and survival status 6 months after hospital discharge were significantly lower in patients with hematologic malignancy than in those with nonhematologic malignancy (13.3% vs. 38.2%, P = .026 and 3.3% vs. 26.5%, P = .017, respectively). Multivariate analysis identified an active hematologic malignancy, older age, acidosis, thrombocytopenia, high vasoactive-inotrope score, and respiratory failure as the risk factors for in-hospital death. Patients with hematologic malignancy requiring extracorporeal membrane oxygenation support had significantly lower rates of hospital survival and 6-month survival after discharge than patients with nonhematologic malignancy. Therefore, extracorporeal membrane oxygenation for treating cardiac or respiratory failure should only be considered in highly selected patients with hematologic malignancy.

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The Outcome of Extracorporeal Life Support After General Thoracic Surgery: Timing of Application

Cited by 11 publications

References 20 publications

Extracorporeal membrane oxygenation for postoperative complications in general thoracic surgery: a ten years experience of a university referral centre

Extracorporeal membrane oxygenation for postoperative complications in general thoracic surgery: a ten years experience of a university referral centre

Trends, Advantages and Disadvantages in Combined Extracorporeal Lung and Kidney Support From a Technical Point of View

Outcomes of extracorporeal membrane oxygenation in adults with active hematologic and nonhematologic malignancy

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