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Improvement in the survival rates of extracorporeal membrane oxygenation-supported respiratory failure patients: a multicenter retrospective study in Korean patients

Cited 2 time in Web of Science Cited 2 time in Scopus
Authors
Baek, Moon Seong; Lee, Sang-Min; Chung, Chi Ryang; Cho, Woo Hyun; Cho, Young-Jae; Park, Sunghoon; Koo, So-My; Jung, Jae-Seung; Park, Seung Yong; Chang, Youjin; Kang, Byung Ju; Kim, Jung-Hyun; Oh, Jin Young; Park, So Hee; Yoo, Jung-Wan; Sim, Yun Su; Hong, Sang-Bum
Issue Date
2019-01-03
Publisher
BioMed Central
Citation
Critical Care, 23(1):1
Keywords
Extracorporeal membrane oxygenationUtilizationSurvival
Abstract
Background
Although the utilization of extracorporeal membrane oxygenation (ECMO) is increasing and its technology is evolving, only a few epidemiologic reports have described the uses and outcomes of ECMO. The aim of this study was to investigate the changes in utilization and survival rate in patients supported with ECMO for severe respiratory failure in Korea.

Methods
This was a multicenter study on consecutive patients who underwent ECMO across 16 hospitals in Korea. The records of all patients who required ECMO for acute respiratory failure between 2012 and 2015 were retrospectively reviewed, and the utilization of ECMO was analyzed over time.

Results
During the study period, 5552 patients received ECMO in Korea as a whole, and a total of 2472 patients received ECMO at the participating 16 hospitals. We analyzed 487 (19.7%) patients who received ECMO for respiratory failure. The number of ECMO procedures provided for respiratory failure increased from 104 to 153 during the study period. The in-hospital survival rate increased from 30.8% to 35.9%. The use of prone positioning increased from 6.8% to 49.0% (p < 0.001), and the use of neuromuscular blockers also increased from 28.2% to 58.2% (p < 0.001). Multiple regression analysis showed that old age (OR 1.038 (95% CI 1.022, 1.054)), use of corticosteroid (OR 2.251 (95% CI 1.153, 4.397)), continuous renal replacement therapy (OR 2.196 (95% CI 1.135, 4.247)), driving pressure (OR 1.072 (95% CI 1.031, 1.114)), and prolonged ECMO duration (OR 1.020 (95% CI 1.003, 1.038)) were associated with increased odds of mortality.

Conclusions
Utilization of ECMO and survival rates of patients who received ECMO for respiratory failure increased over time in Korea. The use of pre-ECMO prone positioning and neuromuscular blockers also increased during the same period.
ISSN
1364-8535
Language
English
URI
http://hdl.handle.net/10371/147092
DOI
https://doi.org/10.1186/s13054-018-2293-5
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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