Publication: Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study
Issued Date
2020-01-01
Resource Type
ISSN
14732300
03000605
03000605
Other identifier(s)
2-s2.0-85087316084
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of International Medical Research. Vol.48, No.6 (2020)
Suggested Citation
Surat Tongyoo, Chairat Permpikul, Siwalai Sucher, Preecha Thomrongpairoj, Akekarin Poompichet, Ranistha Ratanarat, Nitipatana Chierakul Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study. Journal of International Medical Research. Vol.48, No.6 (2020). doi:10.1177/0300060520935704 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/57746
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study
Other Contributor(s)
Abstract
© The Author(s) 2020. Objective: To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010. Methods: This retrospective cohort study enrolled adults with severe ARDS (PaO2/FiO2 ratio of <100 with FiO2 of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. The primary outcome was hospital mortality. Results: Sixty-four patients (ECMO, n = 30; mechanical ventilation, n = 34) were recruited. There was no significant difference in the baseline PaO2/FiO2 ratio (67.2 ± 25.7 vs. 76.6 ± 16.0), FiO2 (97 ± 9 vs. 94 ± 8), or Murray score (3.4 ± 0.5 vs. 3.3 ± 0.5) between the ECMO and mechanical ventilation groups. The hospital mortality rate was also not significantly different between the two groups (ECMO, 20/30 [66.7%] vs. mechanical ventilation, 24/34 [70.6%]). Patients who underwent ECMO were ventilated with a significantly lower TV than patients who underwent mechanical ventilation (3.8 ± 1.8 vs. 6.6 ± 1.4 mL, respectively). Conclusion: Although VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT 04031794).