University of Utah, Department of Surgery 30 North 1900 East, Salt Lake City, UT 84132, United States.
Burns. 2019 Mar;45(2):317-321. doi: 10.1016/j.burns.2018.10.012. Epub 2018 Nov 11.
Acute respiratory distress syndrome (ARDS) is a complication that affects approximately 40% of burn patients and is associated with high mortality rates. Extracorporeal membrane oxygenation (ECMO) therapy is a management option for severe refractory hypoxemic respiratory failure; however, there is little literature reporting the effectiveness of this therapy in burns. Our study objective was to review patient outcomes in burns following severe ARDS treated with ECMO.
We retrospectively reviewed all patients treated with ECMO for ARDS who received their burn care at a single regional burn center between 9/1/2006 and 8/31/2016. Primary patient outcome examined was discharge disposition.
We identified 8 patients who had ARDS secondary to burn who were placed onto ECMO during this 10-year period. The average APACHE score, SOFA score, and P/F ratio were 21±3, 9±2, and 59±8, respectively, at the time of decision for ECMO. No ECMO-related complications were identified. Out of the 8 patients reviewed, 1 died, 4 were discharged to acute rehabilitation or a long-term acute care facility, and 3 were discharged to home.
Mortality in burn patients with ARDS who are managed with ECMO is extremely low. Careful selection and timely intervention with ECMO contributed to good clinical outcomes.
急性呼吸窘迫综合征（ARDS）是一种影响约 40%烧伤患者的并发症，与高死亡率相关。体外膜肺氧合（ECMO）治疗是严重难治性低氧性呼吸衰竭的一种治疗选择；然而，关于该疗法在烧伤中的有效性的文献很少。我们的研究目的是回顾接受 ECMO 治疗的严重 ARDS 烧伤患者的预后。
我们回顾性分析了 2006 年 9 月 1 日至 2016 年 8 月 31 日期间在一家区域性烧伤中心接受 ECMO 治疗 ARDS 的所有烧伤患者。主要观察指标为出院去向。
在这 10 年期间，我们确定了 8 名因烧伤而继发 ARDS 的患者接受 ECMO。决定使用 ECMO 时，患者的平均急性生理与慢性健康评分（APACHE）、序贯器官衰竭评分（SOFA）和氧合指数（P/F）分别为 21±3、9±2 和 59±8。未发现与 ECMO 相关的并发症。在回顾的 8 名患者中，1 人死亡，4 人出院至急性康复或长期急性护理机构，3 人出院回家。
接受 ECMO 治疗的 ARDS 烧伤患者的死亡率极低。ECMO 的精心选择和及时干预有助于获得良好的临床结果。
