Prognostic Factors for Adult Patients Receiving Extracorporeal Membrane Oxygenation as Mechanical Circulatory Support-A 14-Year Experience at a Medical Center

• Published in: Artificial organs Vol. 34; no. 2; pp. E59 - E64
• Main Authors: Lan, Chinchun, Tsai, Pi-Ru, Chen, Yih-Sharng, Ko, Wen-Je
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.02.2010
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cause of Death; Chi-Square Distribution; Extracorporeal Membrane Oxygenation; Female; Heart Failure - mortality; Heart Failure - therapy; Humans; Male; Mechanical circulatory support; Middle Aged; Patient Selection; Prognosis; Prognostic factor; Regression Analysis; Respiratory Insufficiency - mortality; Respiratory Insufficiency - therapy; Retrospective Studies; Risk Factors; Treatment Outcome
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.2009.00909.x

Extracorporeal membrane oxygenation (ECMO) is a resource‐consuming and highly invasive treatment. There were 1100 ECMO cases at the National Taiwan University Hospital between August 1994 and November 2008. Of these, 607 were adults (>18 years old) who received ECMO as mechanical circulatory support. In this study, patient characteristics and complications during the ECMO course were evaluated for their correlation with prognosis. The following factors were significantly different between survivors and nonsurvivors: age, coronary artery disease, diabetes mellitus, brain death, stroke during ECMO, the need for dialysis during ECMO, pre‐ECMO infection, hypoglycemia, acidosis, alkalosis, the need for a distal perfusion catheter, and the amount of red blood cells transfused. Six independent predictors of mortality were identified: age, stroke, the need for dialysis during ECMO, pre‐ECMO infection, hypoglycemia, and alkalosis. Our institution has comparatively extensive experience with adult patients, which may be quite different from other medical centers with respect to distribution of patient age. The findings should lead to better utilization of ECMO for adult patients in the future.