Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro, 173, Beon-gil, Bundang-gu, Seongnam, 13620, South Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, South Korea.
Sci Rep. 2022 Mar 28;12(1):5225. doi: 10.1038/s41598-022-09230-9.
We examined and compared the clinical characteristics of acute respiratory distress syndrome (ARDS) patients who received and did not receive extracorporeal membrane oxygenation (ECMO) support. The national health insurance database of South Korea was used to obtain real-world data. All adult patients admitted to intensive care units for ARDS treatment between 1 January 2014 and 31 December 2019 were included in this study. Of the 10,173 patients with ARDS included in the analysis, 740 (7.3%) received ECMO support for a mean duration of 1.6 days (standard deviation [SD]: 2.8 days) and were assigned to the ECMO group. The ECMO group had a significantly lower mean age at 57.0 years (SD: 15.7 years) than the non-ECMO group (71.8 Â years [SD: 15.1 Â years], P < 0.001). In multivariable logistic regression, a 1-year increase in age was associated with a 5% lower prevalence of ECMO support. The annual case volume was classified into four groups by quartile ratio (Q1 [lowest], Q2, Q3, and Q4 [highest]), and Q2, Q3, and Q4 groups showed a higher prevalence of ECMO support than the Q1 group. ECMO support was also performed more frequently in high case volume centers than in low case volume centers for ARDS patients.
我们考察并比较了接受和未接受体外膜肺氧合（ECMO）支持的急性呼吸窘迫综合征（ARDS）患者的临床特征。使用韩国国家健康保险数据库获取真实世界数据。本研究纳入了 2014 年 1 月 1 日至 2019 年 12 月 31 日期间因 ARDS 入住重症监护病房的所有成年患者。在纳入分析的 10173 例 ARDS 患者中，740 例（7.3%）接受 ECMO 支持，平均持续时间为 1.6 天（标准差 [SD]：2.8 天），并被分配到 ECMO 组。ECMO 组的平均年龄为 57.0 岁（SD：15.7 岁），显著低于非 ECMO 组（71.8 岁 [SD：15.1 岁]，P<0.001）。在多变量逻辑回归中，年龄增加 1 岁与 ECMO 支持率降低 5%相关。按四分位比（Q1[最低]、Q2、Q3 和 Q4[最高]）将年度病例量分为四组，Q2、Q3 和 Q4 组的 ECMO 支持率高于 Q1 组。与低病例量中心相比，高病例量中心对 ARDS 患者进行 ECMO 支持的频率也更高。
