Mariappan Ramadevi, Kumar Madhan, Ramakrishnan Nagarajan, Mani Ashwin K, Kumar Senthil, Chandrasekaran Vignesh
Apollo Hospitals, Chennai, Tamil Nadu, India.
Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu, India.
Indian J Crit Care Med. 2021 Nov;25(11):1263-1268. doi: 10.5005/jp-journals-10071-23928.
Extracorporeal membrane oxygenation (ECMO) is increasingly used in managing patients with severe acute respiratory distress syndrome (ARDS). The aim of the study is to describe the practice of ECMO and evaluate the outcomes in patients with severe ARDS in Indian intensive care units (ICUs).
Data of 39 patients with severe ARDS managed with ECMO in two tertiary centers between 2012 and 2018 were retrospectively studied.
The mean age of the patient was 44.6 ± 13.5 years and 51% were female. Primary ARDS due to viral pneumonia was the common indication for ECMO. Mean APACHE II and Murray scores were 32.3 ± 7.8 and 3.64 ± 0.21, respectively. Prone ventilation and/or inhaled nitric oxide were used in 69.3% of the patients prior to ECMO therapy. Among 39 patients, 38 patients were managed with venovenous ECMO and 1 patient was managed with venoarterial ECMO. Average ECMO duration was 9.4 ± 6.9 days. Among the 17 (43.5%) patients successfully weaned off ECMO, 15 (38.5%) survived to discharge home. The average ICU and hospital length of stay were 18.9 ± 15.5 and 20.6 ± 16.6 days, respectively. While, sepsis was the common complication noted in 19 (49%) patients, bleeding and thrombotic complications were also noted in six and two patients, respectively.
In conclusion, ECMO support was used as rescue therapy in severe ARDS with a survival rate of 39%. Sepsis was the common complication of ECMO followed by bleeding and thrombosis.
Mariappan R, Kumar M, Ramakrishnan N, Mani AK, Kumar S, Chandrasekaran V. Practice Patterns and Outcome of Extracorporeal Membrane Oxygenation Therapy for Severe Acute Respiratory Distress Syndrome in Indian ICUs. Indian J Crit Care Med 2021;25(11):1263-1268.
体外膜肺氧合（ECMO）在治疗重症急性呼吸窘迫综合征（ARDS）患者中的应用日益广泛。本研究旨在描述印度重症监护病房（ICU）中ECMO的应用情况，并评估重症ARDS患者的治疗结果。
回顾性研究了2012年至2018年间两个三级中心使用ECMO治疗的39例重症ARDS患者的数据。
患者的平均年龄为44.6±13.5岁，51%为女性。病毒性肺炎所致的原发性ARDS是ECMO的常见适应证。APACHE II评分和Murray评分的平均值分别为32.3±7.8和3.64±0.21。69.3%的患者在接受ECMO治疗前使用了俯卧位通气和/或吸入一氧化氮。39例患者中，38例采用静脉-静脉ECMO治疗，1例采用静脉-动脉ECMO治疗。ECMO的平均持续时间为9.4±6.9天。在17例（43.5%）成功脱离ECMO的患者中，15例（38.5%）存活出院。ICU和医院的平均住院时间分别为18.9±15.5天和20.6±16.6天。同时，19例（49%）患者出现败血症这一常见并发症，6例和2例患者分别出现出血和血栓形成并发症。
总之，ECMO支持被用作重症ARDS的挽救治疗，生存率为39%。败血症是ECMO的常见并发症，其次是出血和血栓形成。
Mariappan R, Kumar M, Ramakrishnan N, Mani AK, Kumar S, Chandrasekaran V. 印度ICU中重症急性呼吸窘迫综合征体外膜肺氧合治疗的实践模式与结果。《印度重症监护医学杂志》2021；25(11):1263 - 1268。
