Erschienen in:
01.10.2006 | Original
Treatment of severe acute respiratory distress syndrome: role of extracorporeal gas exchange
verfasst von:
Martin Beiderlinden, Matthias Eikermann, Tanja Boes, Christa Breitfeld, Jürgen Peters
Erschienen in:
Intensive Care Medicine
|
Ausgabe 10/2006
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Abstract
Objective
To evaluate the effect of extracorporeal gas exchange (ECMO) on mortality of patients referred with severe acute respiratory distress syndrome (ARDS).
Design and setting
Prospective observational study in a university hospital ICU.
Patients
150 patients with severe ARDS.
Interventions
Multimodal treatment with and without ECMO.
Measurements and main results
We treated 118 patients (78.7%) conservatively and 32 patients with ECMO. Patients in the ECMO group presented with significantly more severe disease (lung injury score 3.8 ± 0.3 vs. 3.3 ± 0.4; SOFA score 52 ± 14 vs. 43 ± 12; and SAPS score 14 ± 3.3 vs. 10 ± 3.5). Mortality in ECMO-treated patients tended to be higher than that with conservative treatment (46.9% vs. 28.8%, p = 0.059). Multivariate logistic regression analyses with backward selection excluded ECMO as predictor of mortality (p = 0.79). Independent predictors of mortality were age (odds ratio 1.044, 95% confidence interval 1.014–1.075, p = 0.004), mean pulmonary artery pressure (1.082, 1.026–1.141, p = 0.036), sequential organ failure assessment score (1.148, 1.018–1.294, p = 0.024), and days of mechanical ventilation prior to referral (1.064, 1.008–1.123, p = 0.025).
Conclusion
ECMO treatment does not predict mortality in patients with most severe ARDS.