Korean J Crit Care Med.  2014 Nov;29(4):266-272. 10.4266/kjccm.2014.29.4.266.

Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome

• Cho WH
• Kim DW
• Yeo HJ
• Yoon SH
• Lee SE
• Jeon DS
• Kim YS
• Son BS
• Kim DH

• KMID: 2227733
• DOI: http://doi.org/10.4266/kjccm.2014.29.4.266

Abstract

BACKGROUND
Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS.
METHODS
We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group.
RESULTS
From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock.
CONCLUSIONS
In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.

Keyword

aged; extracorporeal membrane oxygenation; respiratory distress syndrome, adult

MeSH Terms

Acute Kidney Injury
Aged*
Extracorporeal Membrane Oxygenation
Humans
Intensive Care Units
Medical Records
Patients' Rooms
Respiratory Distress Syndrome, Adult*
Retrospective Studies
Shock, Septic
Ventilator-Induced Lung Injury

Reference

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