Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Thoracic and Cardiovascular Surgery, Busan Medical Center, Yeonje-Gu, Busan, Korea.
Ann Thorac Cardiovasc Surg. 2021 Apr 20;27(2):97-104. doi: 10.5761/atcs.oa.20-00224. Epub 2021 Feb 3.
Extracorporeal membrane oxygenation (ECMO) as intraoperative cardiorespiratory support during lung transplantation is well known, but use for other types of surgery are limited. To assess risk factor for mortality after high-risk thoracic surgery and feasibility of ECMO, we reviewed.
This study was an observational study. Between January 2011 and October 2018, 63 patients underwent thoracic surgery with ECMO for severe airway disease, pulmonary insufficiency requiring lung surgery, and other conditions.
In all, 46 patients remained alive at 30 days after surgery. The mean patient age was 50.38 ± 16.16 years. ECMO was most commonly used to prevent a lethal event (34 [73.9%]) in the Survival (S) group and rescue intervention (13 [76.5%]) in the Non-survival (N) group. In all, 11 patients experienced arrest during surgery (S vs N: 2 [4.3%] vs 9 [52.9%], p ≤0.001). The multivariate analysis revealed that arrest during surgery (odds ratio [OR], 24.44; 95% confidence interval [CI], 1.82-327.60; p = 0.016) and age (OR, 7.47; 95% CI, 1.17-47.85; p = 0.034) were independently associated with mortality.
ECMO provides a safe environment during thoracic surgery, and its complication rate is acceptable except for extracorporeal cardiopulmonary resuscitation (ECPR).
体外膜肺氧合（ECMO）作为肺移植术中的心肺呼吸支持已广为人知，但在其他类型的手术中的应用有限。为了评估高危胸部手术后的死亡风险因素和 ECMO 的可行性，我们进行了回顾性研究。
这是一项观察性研究。2011 年 1 月至 2018 年 10 月，63 例患者因严重气道疾病、需要肺手术的肺功能不全以及其他情况接受了带 ECMO 的胸部手术。
共有 46 例患者在手术后 30 天存活。患者平均年龄为 50.38 ± 16.16 岁。ECMO 最常用于预防生存（S）组中的致命事件（34 例[73.9%]）和非生存（N）组中的抢救干预（13 例[76.5%]）。共有 11 例患者在手术中出现心脏骤停（S 组与 N 组：2[4.3%]与 9[52.9%]，p≤0.001）。多变量分析显示，手术中发生心脏骤停（比值比[OR]，24.44；95%置信区间[CI]，1.82-327.60；p=0.016）和年龄（OR，7.47；95%CI，1.17-47.85；p=0.034）与死亡率独立相关。
ECMO 在胸部手术中提供了一个安全的环境，除了体外心肺复苏（ECPR）外，其并发症发生率是可以接受的。
