Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenationReport as inadecuate




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Critical Care

, 20:392

First Online: 05 December 2016DOI: 10.1186-s13054-016-1568-y

Cite this article as: Rozencwajg, S., Pilcher, D., Combes, A. et al. Crit Care 2016 20: 392. doi:10.1186-s13054-016-1568-y

Abstract

Extracorporeal membrane oxygenation ECMO for severe acute respiratory distress syndrome ARDS has known a growing interest over the last decades with promising results during the 2009 AH1N1 influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance.

Survival has steadily improved for a decade, reaching up to 65% at hospital discharge in the most recent cohorts. However, ECMO is still marred by frequent and significant complications such as bleeding and nosocomial infections. In addition, physiological and psychological symptoms are commonly described in long-term follow-up of ECMO-treated ARDS survivors. Because this therapy is costly and exposes patients to significant complications, seven prediction models have been developed recently to help clinicians identify patients most likely to survive once ECMO has been initiated and to facilitate appropriate comparison of risk-adjusted outcomes between centres and over time. Higher age, immunocompromised status, associated extra-pulmonary organ dysfunction, low respiratory compliance and non-influenzae diagnosis seem to be the main determinants of poorer outcome.

KeywordsExtracorporeal membrane oxygenation Acute respiratory distress syndrome Outcome Predictive survival models ECMO-related complications  Download fulltext PDF



Author: Sacha Rozencwajg - David Pilcher - Alain Combes - Matthieu Schmidt

Source: https://link.springer.com/



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