Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
J Crit Care. 2021 Feb;61:103-106. doi: 10.1016/j.jcrc.2020.10.017. Epub 2020 Oct 24.
Legionella pneumonia with acute respiratory failure may necessitate extracorporeal membrane oxygenation (ECMO). The medical literature in this area is comprised primarily of case reports and small case series. Our goal was to summarize published data and contribute our institutional experience regarding survival in severe Legionella pneumonia requiring ECMO.
A National Library of Medicine (PubMed) search was conducted, identifying reports of ECMO therapy in patients with severe Legionella pneumonia. Electronic health records of Montefiore Medical Center (Bronx, NY) captured all such patients treated at our institution during the 10-year period 2010-2019.
23 articles reported 73 patients. Survival to hospital discharge was 78.1%. In an attempt to avoid publication bias, we culled from the search four series (53 patients), reporting surviving and non-surviving patients. Survival in this group was 71.7%. Our institutional experience included 10 patients with survival rate 80%.
Review of clinical experience with ECMO for severe Legionella pneumonia yields a survival rate of over 70%. The similarity in survival rates among all published cases (78.1%), case series reporting surviving and non-surviving patients (71.7%), our institutional experience (80%), and recently reported Extracorporeal Life Support Organization (ELSO) registry data (71%) supports the veracity of this encouraging survival rate.
军团菌肺炎伴急性呼吸衰竭可能需要体外膜氧合（ECMO）治疗。该领域的医学文献主要由病例报告和小病例系列组成。我们的目标是总结已发表的数据，并介绍我们机构在需要 ECMO 治疗的严重军团菌肺炎患者的生存方面的经验。
在国家医学图书馆（PubMed）上进行了检索，确定了使用 ECMO 治疗严重军团菌肺炎患者的报告。Montefiore 医疗中心（纽约州布朗克斯）的电子病历记录了我们机构在 2010 年至 2019 年这 10 年间治疗的所有此类患者。
23 篇文章报告了 73 例患者。出院时的存活率为 78.1%。为避免发表偏倚，我们从检索中剔除了 4 个系列（53 例），报告了存活和非存活患者。该组的存活率为 71.7%。我们机构的经验包括 10 例存活患者，存活率为 80%。
对严重军团菌肺炎患者使用 ECMO 的临床经验进行回顾，存活率超过 70%。所有已发表病例（78.1%）、报告存活和非存活患者的病例系列（71.7%）、我们机构的经验（80%）以及最近报道的体外生命支持组织（ELSO）登记数据（71%）中存活率相似，这支持了这一令人鼓舞的存活率的真实性。
