Background
Materials and methods
Study design and patients
Data collection
ECMO management
Statistical analyses
Results
Patient characteristics
Characteristic | Total(n = 131) | ECMO(n = 44) | non-ECMO (n = 87) | P -value |
---|---|---|---|---|
Age (years) | 57.85 ± 12.03 | 62.70 ± 6.21 | 56.28 ± 13.02 | 0.04 |
Sex (male/female) | 118/13 | 38/6 | 80/7 | |
BMI (kg/m2) | 19.48 ± 4.08 | 19.26 ± 5.76 | 19.59 ± 3.11 | 0.77 |
Transplant indication | ||||
Lung fibrosis | 77 | 33 | 44 | 0.009 |
IPF | 16 | 10 | 6 | 0.02 |
NSIP | 29 | 12 | 17 | 0.52 |
Pneumosilicosis | 7 | 3 | 4 | 0.69 |
CTD-fibrosis | 15 | 3 | 12 | 0.30 |
Other | 10 | 5 | 5 | 0.30 |
COPD | 47 | 6 | 41 | < 0.01 |
Re-transplant | 2 | 2 | 0 | 0.045 |
Bronchiectasis hemoptysis | 5 | 3 | 2 | 0.33 |
Co-morbidities | ||||
Hypertension | 18 | 5 | 13 | 0.79 |
Diabetes mellitus | 19 | 10 | 9 | 0.07 |
Barotrauma | 11 | 5 | 6 | 0.51 |
LAS | 58.63 ± 18.39 | 61.89 ± 18.63 | 55.85 ± 15.22 | 0.056 |
APACHE II score | 17.54 ± 8.23 | 22.48 ± 1.87 | 15.28 ± 7.08 | < 0.01 |
Characteristic | Total(n = 131) | ECMO(n = 44) | non-ECMO (n = 87) | P value |
---|---|---|---|---|
Operative time | 7.03 ± 2.71 | 8.74 ± 2.32 | 6.09 ± 2.45 | < 0.01 |
Single lung | 78 | 21 | 57 | 0.06 |
Bilateral lung | 53 | 23 | 30 | 0.06 |
Lung volume reduction | 4 | 0 | 4 | 0.30 |
Intraoperative transfusion | 8.52 ± 9.25 | 12.94 ± 8.64 | 6.78 ± 5.05 | < 0.01 |
Preoperative mechanical ventilation | 5.08 ± 9.00 | 6.38 ± 9.04 | 1.37 ± 4.69 | 0.01 |
Preoperative intensive care unit | 2.76 ± 6.61 | 7.67 ± 9.12 | 2.60 ± 7.23 | 0.02 |
PAP (mmHg) | 44.67 ± 13.08 | 50.83 ± 1.20 | 40.58 ± 14.84 | 0.01 |
Donor data | ||||
Age (years) | 34.00 ± 12.11 | 35.00 ± 16.58 | 32.54 ± 10.84 | 0.52 |
Travel time(h) | 4.62 ± 2.31 | 5.24 ± 4.12 | 4.29 ± 3.15 | 0.058 |
Ventilation (days) | 4.19 ± 5.77 | 4.94 ± 6.83 | 2.44 ± 1.54 | 0.14 |
Characteristic | Total(n = 131) | ECMO(n = 44) | non-ECMO (n = 87) | P value | |
---|---|---|---|---|---|
PaO2/FiO2 | Before | 83.68 ± 45.99 | 75.93 ± 31.74 | 87.13 ± 51.01 | 0.05 |
After | 175.10 ± 85.64 | 192.40 ± 103.5 | 167.40 ± 76.45 | 0.28 | |
PaCO2 | Before | 55.74 ± 13.75 | 56.30 ± 14.88 | 55.38 ± 13.14 | 0.78 |
After | 43.73 ± 10.25 | 37.30 ± 10.14 | 47.81 ± 8.05 | < 0.01 | |
WBC count, 109/L | Before | 9.03 ± 4.55 | 10.33 ± 6.02 | 8.57 ± 3.72 | 0.16 |
After | 13.93 ± 10.28 | 11.99 ± 7.37 | 15.01 ± 11.49 | 0.29 | |
Lymphocytes | Before | 0.87 ± 0.66 | 0.92 ± 0.72 | 0.84 ± 0.65 | 0.65 |
After | 0.43 ± 0.30 | 0.57 ± 0.42 | 0.38 ± 0.22 | 0.02 | |
Hemoglobin | Before | 107.40 ± 22.75 | 98.00 ± 16.75 | 108.80 ± 18.63 | 0.03 |
After | 118.3 ± 23.07 | 102.60 ± 16.39 | 124.90 ± 22.75 | < 0.01 | |
Lactate, mmol/L | Before | 1.12 ± 0.96 | 1.26 ± 0.86 | 1.06 ± 1.02 | 0.47 |
After | 4.78 ± 2.99 | 5.97 ± 3.62 | 4.24 ± 2.52 | 0.03 | |
PLT, 109/L | Before | 193.70 ± 88.49 | 182.30 ± 95.36 | 200.60 ± 87.26 | 0.45 |
After | 129.10 ± 60.20 | 106.20 ± 54.05 | 140.70 ± 61.32 | 0.04 | |
Serum creatinine | Before | 60.95 ± 23.45 | 70.30 ± 28.36 | 56.72 ± 19.94 | 0.03 |
After24h | 96.88 ± 50.56 | 124.60 ± 57.08 | 81.48 ± 37.48 | < 0.01 | |
After48h | 85.17 ± 51.47 | 122.00 ± 56.42 | 65.93 ± 32.68 | < 0.01 |
Patient outcomes and statistical analyses
Complications | Total(n = 131) | ECMO(n = 44) | non-ECMO (n = 87) | P value |
---|---|---|---|---|
Bleed | 6 | 4 | 2 | 0.09 |
Renal failure | 15 | 11 | 4 | < 0.01 |
Ventilation after operation | 18.97 ± 32.51 | 25.21 ± 38.50 | 17.22 ± 29.13 | 0.37 |
Length of ICU stay, days | 24.75 ± 27.24 | 34.52 ± 35.02 | 20.09 ± 21.56 | 0.05 |
Length ofhospital stay, days | 53.81 ± 33.71 | 55.27 ± 34.95 | 53.14 ± 33.54 | 0.81 |
ICU mortality n(%) | ||||
1 month | 8 (6.10%) | 4 (9.09%) | 4 (4.60%) | 0.44 |
3 month | 27 (20.61%) | 12 (27.27%) | 15 (17.24%) | 0.25 |
12 month | 42 (32.06%) | 19 (43.18%) | 23 (26.44%) | 0.07 |
Univariate logistic regression | Multivariate logistic regression | ||||
---|---|---|---|---|---|
Variables | OR | p | OR | 95%CI | p |
Age > 60 | 14.20 | 0.01 | 11.86 | 1.422–99.08 | 0.02 |
Preoperative mechanical ventilation | 1.11 | 0.01 | 49.45 | 2.85–858.75 | 0.01 |
Preoperative intensive care unit | 1.07 | 0.03 | |||
PAP before operation | 1.07 | 0.01 | 0.91 | 0.83–1.01 | 0.05 |
Preoperative APACHE II | 1.15 | 0.01 | 46.21 | 3.22–662.38 | 0.01 |
Preoperative PaO2/FiO2 | 0.98 | 0.05 | |||
Preoperative hemoglobin | 0.97 | 0.04 | |||
Preoperative serum creatinine | 1.02 | 0.03 | |||
Underlying lung disease | 0.02 | 0.01 | 0.02 | 0.001–0.32 | 0.01 |