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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access
  • Long term outcome after respiratory ecmo and length of ecmo treatment

    • 1,
    • 1,
    • 1 and
    • 1
    Intensive Care Medicine Experimental20153 (Suppl 1) :A153

    https://doi.org/10.1186/2197-425X-3-S1-A153

    • Published:

    Keywords

    • Respiratory Distress
    • Treatment Time
    • Hospital Discharge
    • High Survival
    • Short Length

    Introduction

    Respiratory ECMO is nowadays a common tool in the ICU to help the patient survive despite severe respiratory distress and gas exchange problems. The pathology can be diverse but the most common diagnoses are pneumonia/ARDS. The treatment time depends on several factors, including the underlying pathology, patient characteristics and complications.

    Objectives

    To investigate how long term survival for adults after respiratory ECMO correlates to time on ECMO.

    Methods

    A consecutive cohort of all adults, n = 273, treated in the ECMO ICU of Karolinska University Hospital Stockholm Sweden between 1995-12-15 to 2013-12-30 and followed up to 2014-01-15 was used(1). Data on length of stay on ECMO, and long-term outcome up to five years post ECMO treatment, was extracted. Six different groups was formed depending on length of ECMO treatment. Outcome after ICU and Hospital discharge, 90 days and 5 years was analysed. Alive after 90 days and still alive five years later was also analysed.

    Results

    The highest survival, 74%, was seen in the group with the shortest stay,1-7 days on ECMO. Outcome in this group dropped to 56% survival after 5 years of follow up. With longer ECMO stay, outcome generally, but not linearly, declined and was still 47% ICU survival in the group with up to 56 days on ECMO. The group >56 days of ECMO treatment, containing only six patients, had a 33% ICU outcome. Interestingly in four out of six groups the patients being alive after 90 days had a 75-100% 5 year survival post ECMO treatment.

    Conclusions

    ICU outcome after respiratory ECMO in this cohort study was between 33-74% depending on length of stay on ECMO. Best outcome was seen in the groups with the shortest length of stay. With longer ECMO stay, outcome generally, but not linearly, declined. Interestingly the group being alive 90 days post ECMO had a 5 years survival between 75-100% The findings though need to be carefully interpereted since some of the groups are very small.
    Table 1

    Time on ECMO and long term outcome.

    Time on ECMO days

    n= (total n = 273)

    Alive from ECMO ICU

    Alive at Hospital discharge

    Alive after 90 days

    Alive after 5 years

    Alive after 5 years if alive after 90 days

    1-7 d

    127

    94 (74%)

    91 (72%)

    73 (59%)

    36/64 (56%)

    28/35 (80%)

    8-14 d

    72

    53 (74%)

    51 (72%)

    44/68 (65%)

    15/31 (48%)

    15/17 (88%)

    15-21 d

    22

    12 (55%)

    12 (55%)

    8 (36%)

    2/8 (25%)

    2/2 (100%)

    22-28 d

    17

    12 (71%)

    12 (71%)

    9 (53%)

    6/12 (50%)

    6/8 (75%)

    29-42 d

    12

    5 (42%)

    5 (42%)

    5 (42%)

    0/1 (0%)

    0/0 (0%)

    43-56 d

    17

    8 (47%)

    8 (47%)

    8 (47%)

    3/9 (33%)

    4/4 (100%)

    > 56 d

    6

    2 (33%)

    2 (33%)

    2 (33%)

    0/1 (0%)

    0/0 (0%)

    Declarations

    Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

    Authors’ Affiliations

    (1)
    Karolinska University Hospital, Solna, ECMO ICU, Stockholm, Sweden

    References

    1. von Bahr V, et al: Läkartidningen Nr. 2015, volym 112 (10):Google Scholar

    Copyright

    © Kalzén et al.; 2015

    This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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