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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 N.E.Woo A.Kim S.Y.Leem A.Y.Park Y.Kwak S.H.Yong S.H.Chung K.Park M.S.Kim Y.S.Kim H.E.Lee J.G.Paik H.C.Lee S.H.
Ewha Authors
김남은
SCOPUS Author ID
김남은scopus
Issue Date
2021
Journal Title
Respiratory Research
ISSN
1465-9921JCR Link
Citation
Respiratory Research vol. 22, no. 1
Keywords
Critical careExtracorporeal membrane oxygenationLung transplantationRespiratory function tests
Publisher
BioMed Central Ltd
Indexed
SCIE; SCOPUS 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. © 2021, The Author(s).
DOI
10.1186/s12931-021-01905-7
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의료원 > 의료원 > Journal papers
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