Flinspach Armin N, Raimann Florian J, Bauer Frederike, Zacharowski Kai, Ippolito Angelo, Booke Hendrik
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe-University Frankfurt, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany.
Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, University of Muenster, Albert-Schweitzer-Straße 33, 48149 Muenster, Germany.
J Clin Med. 2023 Mar 25;12(7):2499. doi: 10.3390/jcm12072499.
Veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) therapy has become increasingly used and established in many hospitals as a routine treatment. With ECMO-therapy being a resource-demanding procedure, it is of interest whether a more prolonged VV-ECMO treatment would hold sufficient therapeutic success. Our retrospective study included all VV-ECMO runs from 1 January 2020 to 31 June 2022. We divided all runs into four groups (<14 days, 14-27, 28-49, 50+) of different durations and looked for differences overall in hospital survival. Additionally, corresponding treatments and therapeutic modalities, as well as laboratory results, were analyzed. We included 117 patients. Of those, 97 (82.9%) received a VV-ECMO treatment longer than two weeks. We did not find a significant association between ECMO duration ( = 0.15) and increased mortality though a significant correlation between the patients' age and their probability of survival ( = 0.02). Notably, we found significantly lower interleukin-6 levels with an increase in therapy duration ( < 0.01). Our findings show no association between the duration of ECMO therapy and mortality. Thus, the treatment duration alone may not be used for making assumptions about the prospect of survival. However, attention is also increasingly focused on long-term outcomes, such as post-intensive care syndrome with severe impairments.
静脉-静脉体外膜肺氧合(VV-ECMO)治疗在许多医院已越来越多地被用作常规治疗方法。由于ECMO治疗是一种资源需求较高的治疗手段,延长VV-ECMO治疗是否能取得足够的治疗成功值得关注。我们的回顾性研究纳入了2020年1月1日至2022年6月31日期间所有的VV-ECMO治疗病例。我们将所有治疗病例分为四组,治疗时长分别为<14天、14 - 27天、28 - 49天、50天以上,以探寻总体住院生存率的差异。此外,还对相应的治疗方法、治疗方式以及实验室检查结果进行了分析。我们共纳入了117例患者。其中,97例(82.9%)接受了超过两周的VV-ECMO治疗。尽管患者年龄与生存概率之间存在显著相关性(P = 0.02),但我们未发现ECMO治疗时长(P = 0.15)与死亡率增加之间存在显著关联。值得注意的是,我们发现随着治疗时长增加,白细胞介素-6水平显著降低(P < 0.01)。我们的研究结果表明,ECMO治疗时长与死亡率之间无关联。因此,不能仅依据治疗时长来推断生存前景。然而,人们也越来越关注长期预后,如伴有严重功能障碍的重症监护后综合征。