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Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
- Title
- Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
- Authors
- Kim, Nam Eun; Woo, Ala; Kim, Song Yee; Leem, Ah Young; Park, Youngmok; Kwak, Se Hyun; Yong, Seung Hyun; Chung, Kyungsoo; Park, Moo Suk; Kim, Young Sam; Kim, Ha Eun; Lee, Jin Gu; Paik, Hyo Chae; Lee, Su Hwan
- Ewha Authors
- 김남은
- SCOPUS Author ID
- 김남은
- Issue Date
- 2021
- Journal Title
- RESPIRATORY RESEARCH
- ISSN
- 1465-993X
- Citation
- RESPIRATORY RESEARCH vol. 22, no. 1
- Keywords
- Extracorporeal membrane oxygenation; Lung transplantation; Critical care; Respiratory function tests
- Publisher
- BMC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background As lung transplantation (LTx) is becoming a standard treatment for end-stage lung disease, the use of bridging with extracorporeal membrane oxygenation (ECMO) is increasing. We examined the clinical impact of being awake during ECMO as bridging therapy in patients awaiting LTx. Methods In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019; 64 patients received ECMO support while awaiting LTx. We divided into awake and non-awake groups and compared. Results Twenty-five patients (39.1%) were awake, and 39 (61.0%) were non-awake. The median age of awake patients was 59.0 (interquartile range, 52.5-63.0) years, and 80% of the group was men. The awake group had better post-operative outcomes than the non-awake group: statistically shorter post-operative intensive care unit length of stay [awake vs. non-awake, 6 (4-8.5) vs. 18 (11-36), p < 0.001], longer ventilator free days [awake vs. non-awake, 24 (17-26) vs. 0 (0-15), p < 0.001], and higher gait ability after LTx (awake vs. non-awake, 92% vs. 59%, p = 0.004), leading to higher 6-month and 1-year lung function (forced expiratory volume in 1 s: awake vs. non-awake, 6-month, 77.5% vs. 61%, p = 0.004, 1-year, 75% vs. 57%, p = 0.013). Furthermore, the awake group had significantly lower 6-month and 1-year mortality rates than the non-awake group (6-month 12% vs. 38.5%, p = 0.022, 1-year 24% vs. 53.8%, p = 0.018). Conclusions In patients with end-stage lung disease, considering the long-term and short-term impacts, the awake ECMO strategy could be useful compared with the non-awake ECMO strategy.
- DOI
- 10.1186/s12931-021-01905-7
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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