Viktor von Bahr1, Jan Hultman, Staffan Eksborg, Björn Frenckner, Håkan Kalzén. 1. 1Department of Physiology and Pharmacology, Section for Anesthesiology and Intensive Care Medicine, Karolinska Institutet, Stockholm, Sweden. 2ECMO Center Karolinska, Karolinska University Hospital, Stockholm, Sweden. 3Childhood Cancer Research Unit Q6:05, Department of Women's and Children's Health, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden. 4Department of Women's and Children's Health, Pediatric Surgery, Karolinska Institutet and Astrid Lindgren Children's Hospital, Stockholm, Sweden.
Abstract
OBJECTIVE: The use of extracorporeal membrane oxygenation in adults with respiratory failure and sepsis is steadily increasing, but the knowledge on long-term survival in this group is scarce. The aim of the present study was to investigate the 5-year survival rates and causes of late death in this group of patients. DESIGN: Single-center retrospective cohort study. SETTING: Karolinska University Hospital, Stockholm, Sweden. PATIENTS: Adult patients treated with extracorporeal membrane oxygenation for respiratory failure and sepsis between the service being established for adults in 1995 and December 2013. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Survival status was attained from a national Causes of Death registry. Minimal patient background data, along with data on survival and causes of death were collected. Survival rates were calculated using the Kaplan-Meier method. Of 255 subjects, 64% survived to discharge. The median follow-up time in survivors was 4.4 years. There was a high mortality rate within the first months after discharge. In the group of patients who survived the first 90 days after treatment, the 5-year survival rate was 87% and was particularly beneficial in patients treated for infectious diseases (88-100%). Late deaths were seen in most diagnostic groups, but the Kaplan-Meier curves flattened out over time. CONCLUSIONS: Extracorporeal membrane oxygenation treatment in adult patients with respiratory failure and sepsis can be lifesaving in appropriately selected patients. For patients who survive the first months after extracorporeal membrane oxygenation treatment, long-term survival seems good, especially in patients treated for infections.
OBJECTIVE: The use of extracorporeal membrane oxygenation in adults with respiratory failure and sepsis is steadily increasing, but the knowledge on long-term survival in this group is scarce. The aim of the present study was to investigate the 5-year survival rates and causes of late death in this group of patients. DESIGN: Single-center retrospective cohort study. SETTING: Karolinska University Hospital, Stockholm, Sweden. PATIENTS: Adult patients treated with extracorporeal membrane oxygenation for respiratory failure and sepsis between the service being established for adults in 1995 and December 2013. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Survival status was attained from a national Causes of Death registry. Minimal patient background data, along with data on survival and causes of death were collected. Survival rates were calculated using the Kaplan-Meier method. Of 255 subjects, 64% survived to discharge. The median follow-up time in survivors was 4.4 years. There was a high mortality rate within the first months after discharge. In the group of patients who survived the first 90 days after treatment, the 5-year survival rate was 87% and was particularly beneficial in patients treated for infectious diseases (88-100%). Late deaths were seen in most diagnostic groups, but the Kaplan-Meier curves flattened out over time. CONCLUSIONS: Extracorporeal membrane oxygenation treatment in adult patients with respiratory failure and sepsis can be lifesaving in appropriately selected patients. For patients who survive the first months after extracorporeal membrane oxygenation treatment, long-term survival seems good, especially in patients treated for infections.
Authors: Shannon M Fernando; Danial Qureshi; Peter Tanuseputro; Eddy Fan; Laveena Munshi; Bram Rochwerg; Robert Talarico; Damon C Scales; Daniel Brodie; Sonny Dhanani; Anne-Marie Guerguerian; Sam D Shemie; Kednapa Thavorn; Kwadwo Kyeremanteng Journal: Intensive Care Med Date: 2019-09-16 Impact factor: 17.440
Authors: Paolo Meani; Matteo Matteucci; Federica Jiritano; Dario Fina; Francesco Panzeri; Giuseppe M Raffa; Mariusz Kowalewski; Nuccia Morici; Giovanna Viola; Alice Sacco; Fabrizio Oliva; Amal Alyousif; Sam Heuts; Martijn Gilbers; Rick Schreurs; Jos Maessen; Roberto Lorusso Journal: Ann Cardiothorac Surg Date: 2019-01