Extracorporeal membrane oxygenation in near-drowning patients with cardiac or pulmonary failure

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Ho Hyun Ko³  Jae Han Jeong³  Hyoung Soo Kim²  Won Yong Lee³  Kun Il Kim¹ 

[1] Department of Cardiothoracic Surgery, Hallym University Dongtan Sacred Heart Hospital, Seoku-dong, Hwaseong-si 445-907, Gyeonggi-do, Korea;Department of Cardiothoracic Surgery, Hallym University Chuncheon Sacred Heart Hospital, Gyo-dong, Chuncheon-si 200-704, Gangwon-do, Korea;Department of Cardiothoracic Surgery, Hallym University Sacred Heart Hospital, 896, Pyeongchon-dong, Dongan-gu, Anyang-si 431-796, Gyeonggi-do, Korea

关键词: Acute respiratory distress syndrome;    Cardiac or pulmonary failure;    Extracorporeal membrane oxygenation;    Near-drowning;    Drowning;   

Others  :  1151516
DOI  :  10.1186/s13049-014-0077-8

 received in 2014-07-16, accepted in 2014-12-03,  发布年份 2014

【 摘 要 】

Background

The aim of this study was to determine the early outcomes of using extracorporeal membrane oxygenation (ECMO) in near-drowning patients with cardiac or pulmonary failure.

Methods

This study was based on data from 9 patients including 2 children (mean age 33; 8 males, 1 female) who received ECMO after near-drowning between 2008 and 2013. Veno-arterial or veno-arteriovenous ECMO was used in 2 patients with sustained cardiac arrest and veno-venous ECMO was used in 7 patients with severe acute respiratory distress syndrome (ARDS). The means of the partial arterial oxygen pressure (PaO₂), Murray score, sequential organ failure assessment (SOFA) score, and simplified acute physiology score II (SAPS-II) prior to ECMO were 59.7 ± 9.9 mmHg on 100% oxygen, 3.5 ± 0.6, 11.4 ± 1.9, and 73.0 ± 9.2, respectively.

Results

The PaO₂ mean improved to 182 ± 152 mmHg within 2 h post-ECMO. The mean of SOFA score and SAPS-II decreased significantly to 8.6 ± 3.2 (p = 0.013) and 46.4 ± 5.1 (p = 0.008), respectively, at 24 h post-ECMO with mean flow rate of 3.9 ± 0.8 l/min. ECMO was weaned at a mean duration of 188 (range, 43–672) h in all patients. Seven patients were discharged home without neurological sequelae, while 2 patients who had hypoxic brain damage died after further referral. The overall survival with favourable neurological outcomes at 3 months was 77.8%. There were no complications related to ECMO.

Conclusions

ECMO was safe and effective for patients with ongoing cardiac arrest or ARDS after a near-drowning incident and can be used as a resuscitative strategy in near-drowning patients with cardiac or pulmonary failure resistant to conventional ventilator therapy.

【 授权许可】

   
2014 Kim et al.; licensee BioMed Central Ltd.

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