Extracorporeal membrane oxygenation for adult respiratory failure

Giles J. Peek, H. M. Moore, N. Moore, A. W. Sosnowski, R. K. Firmin

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Objectives: To review the first 50 patients to receive extracorporeal membrane oxygenation (ECMO) for respiratory failure at Glenfield Hospital, and to compare them with published series of patients receiving positive pressure ventilation. Design: Retrospective chart review. Setting: Extracorporeal Life Support Organization/European Extracorporeal Life Support Organization recognized ECMO center. Patients: Fifty consecutive patients referred for ECMO with respiratory failure refractory to conventional management between 1989 and 1995. Interventions: None. Measurements and results: Primary end point was survival to hospital discharge, 66%. Other data (mean and SD): Murray Lung Injury Score, 3.4 (0.5); ratio of PaO2 to fraction of inspired oxygen, 65 (36.9) mm Hg; duration of ventilation pre- ECMO, 76.5 (83.7 h); peak airway pressure, 30.6 (7.4) cm H2O; end- expiratory pressure, 10 (3.3) em H2O; minute ventilation, 12.6 (3.32) L/min; age, 30.1 (10.8) years; duration of ECMO, 207.4 (177.8) h; and units of blood transfused, 19 (17.3). Survival was significantly better than two previously reported series of patients receiving positive pressure ventilation (55.6% and 42% survival), p=0.036 and p=0.0006. Odds ratio for improved survival was 0.46 (95% confidence interval, 0.22 to 0.97, p=0.036). Conclusions: Survival with ECMO is 66% for adults with severe respiratory failure. ECMO should be considered in patients who remain hypoxic despite maximal positive pressure ventilation.

Original languageEnglish (US)
Pages (from-to)759-764
Number of pages6
JournalChest
Volume112
Issue number3
StatePublished - 1997
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Respiratory Insufficiency
Positive-Pressure Respiration
Survival
Ventilation
Pressure
Lung Injury
Odds Ratio
Confidence Intervals
Oxygen

Keywords

  • ARDS
  • ECMO
  • Survival

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Peek, G. J., Moore, H. M., Moore, N., Sosnowski, A. W., & Firmin, R. K. (1997). Extracorporeal membrane oxygenation for adult respiratory failure. Chest, 112(3), 759-764.

Extracorporeal membrane oxygenation for adult respiratory failure. / Peek, Giles J.; Moore, H. M.; Moore, N.; Sosnowski, A. W.; Firmin, R. K.

In: Chest, Vol. 112, No. 3, 1997, p. 759-764.

Research output: Contribution to journalArticle

Peek, GJ, Moore, HM, Moore, N, Sosnowski, AW & Firmin, RK 1997, 'Extracorporeal membrane oxygenation for adult respiratory failure', Chest, vol. 112, no. 3, pp. 759-764.
Peek GJ, Moore HM, Moore N, Sosnowski AW, Firmin RK. Extracorporeal membrane oxygenation for adult respiratory failure. Chest. 1997;112(3):759-764.
Peek, Giles J. ; Moore, H. M. ; Moore, N. ; Sosnowski, A. W. ; Firmin, R. K. / Extracorporeal membrane oxygenation for adult respiratory failure. In: Chest. 1997 ; Vol. 112, No. 3. pp. 759-764.
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