Lee WooSurng, Kim YoHan, Choi HyunHee, Kim HyoungSoo, Lee SunHee, Lee HeeSung, Chee HyunKeun, Kim JunSeok, Hwang JaeJoon, Lee SongAm, Kim YongHun, Cho SeongJoon, Ryu SeMin, Park SungMin
Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University Chungju Hospital, Konkuk University, Chungju-si, Chungbuk, Republic of Korea.
Department of Internal Medicine and Division of Cardiology, College of Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon-si, Gangwon-do, Republic of Korea.
Biomed Res Int. 2017;2017:3505784. doi: 10.1155/2017/3505784. Epub 2017 Apr 6.
. In most reports on ECMO treatment, advanced age is classified as a contraindication to VA ECMO. We attempted to investigate whether advanced age would be a main risk factor deciding VA ECMO application and performing VA ECMO support. We determined whether advanced age should be regarded as an absolute or relative contraindication to VA ECMO and could affect weaning and survival rates of VA ECMO patients. VA ECMO was performed on 135 adult patients with primary cardiogenic shock between January 2010 and December 2014. Successful weaning was defined as weaning from ECMO followed by survival for more than 48 hours. . Among the 135 patients, 35 survived and were discharged uneventfully, and the remaining 100 did not survive. There were significant differences in survival between age groups, and older age showed a lower survival rate with statistical significance ( = .01). By multivariate logistic regression analysis, age was not significantly associated with in-hospital mortality ( = .83) and was not significantly associated with VA ECMO weaning ( = .11). Advanced age is an undeniable risk factor for VA ECMO; however, patients of advanced age should not be excluded from the chance of recovery after VA ECMO treatment.
在大多数关于体外膜肺氧合（ECMO）治疗的报告中，高龄被列为静脉-动脉（VA）ECMO的一项禁忌证。我们试图研究高龄是否会成为决定VA ECMO应用及实施VA ECMO支持的主要风险因素。我们判定高龄是否应被视为VA ECMO的绝对或相对禁忌证，以及其是否会影响VA ECMO患者的撤机及生存率。在2010年1月至2014年12月期间，对135例患有原发性心源性休克的成年患者实施了VA ECMO治疗。成功撤机定义为从ECMO撤机并存活超过48小时。在这135例患者中，35例存活并顺利出院，其余100例未存活。各年龄组之间的生存率存在显著差异，高龄患者的生存率较低，具有统计学意义（P = 0.01）。通过多因素逻辑回归分析，年龄与院内死亡率无显著相关性（P = 0.83），与VA ECMO撤机也无显著相关性（P = 0.11）。高龄是VA ECMO不可否认的风险因素；然而，不应将高龄患者排除在VA ECMO治疗后恢复的机会之外。
