Background
Outcomes of severe ARDS patients with and without ECMO
Outcomes of severe ARDS treated with “conventional” management
Outcomes of ARDS treated with venovenous ECMO
Long-term outcome
Study | Cohort enrolment | Total population | Follow-up | Primary outcome | Long-term outcomes | |
---|---|---|---|---|---|---|
population | Median time | |||||
Peek et al.[4] | 2001–2006 | 68 | 52 | 6 months | Death or severe disability at 6 months | Lung function evaluated with PFT, overall health status, HRQoL, depression and anxiety symptoms |
Lindén et al.[29] | Before 2009 | 37 | 21 | 26 (12–50) months | Pulmonary morphology (CT scan) | Lung function (PFT), pulmonary symptoms (SGRQ) |
Hodgson et al.[33] | 2009–2011 | 34 | 15 | 9 (8–19) months | HRQoL (SF-36) | Related ECMO complications, survival, discharge destination, return-to-work status |
Luyt et al.[31] | Winter 2009 | 67 | 12 | 12 months | HRQoL (SF-36) | Symptoms and activities since hospital discharge, weight and muscle-strength testing, lung morphology (CT scan), anxiety and depression (HAD scale), symptoms of PTSD (IES) |
Schmidt et al.[6] | 2008–2012 | 140 | 67 | 17 (11–28) months | Factors associated with death at 6 months | HRQoL (SF-36 score), pulmonary symptoms (SGRQ), anxiety and depression (HAD scale), symptoms of PTSD (IES) |
Li et al.[30] | 2009–2012 | 29 | 8 | 12 months | Pulmonary morphology |
ECMO-related complications
Survival prediction models
Objectives of these scores
Survival prediction scores
Score | Population | Number of patients | Number of centres | Cohort enrolment | Pre-ECMO items | Internal validation’s AUROC | External validation’s AUROC | |
---|---|---|---|---|---|---|---|---|
ECMOnet score: Pappallardo et al. [53] | A(H1N1) influenza-related ARDS | 60 | 14 | Winter 2009 | 1. Pre-ECMO LOS 2. Bilirubin 3. Creatinine | 4. Haematocrit level 5. Mean arterial pressure | 0.86 | 0.69a, 0.60b
|
PRESERVE score: Schmidt et al. [6] | Severe ARDS | 140 | 3 | 2008–2012 | 1. Age 2. Body mass index 3. Immunocompromised 4. SOFA score | 5. Days of MV 6. Prone positioning 7. PEEP 8. Plateau pressure | 0.89 | 0.68b, 0.75c
|
RESP score: Schmidt et al. [27] | Acute respiratory failure | 2355 | 280 | 2000–2012 | 1. Age 2. Immunocompromised 3. Days of MV 4. Diagnosis 5. Central nervous system dysfunction 6. Acute associated (non-pulmonary) infection | 7. Neuromuscular blockade agents 8. Nitric oxide use 9. Bicarbonate infusion 10. Cardiac arrest 11. PaCO2
12. Peak inspiratory pressure | 0.74 | 0.92d, 0.81c
|
Roch et al. [28] | ARDS brought to a referral centre | 85 | 1 | 2009–2013 | 1. Age 2. SOFA score 3. Influenza | 0.80 | No | |
Enger et al. [54] | ARDS | 284 | 1 | 2008–2013 | 1. Age 2. Immunocompromised 3. Minute ventilation | 4. Haemoglobin 5. Lactate | 0.75 | No |
Liu et al. [55] | ARDS | 38 | 1 | 2009–2014 | 1. Barotraumae
2. Underlying lung disease | – | – | |
VV-ECMO mortality score: Cheng et al. [56] | Severe ARDS | 116 | 1 | 2007–2015 | 1. Immunocompromised 2. SOFA score 3. Days of MV | 0.76 | No |