초록접수 현황
| 14F-189 | 구연 발표 |
Safe Transition from Cardiopulmonary Bypass (CPB) into Extracorporeal Membrane Oxygenation (ECMO) for Intra-operative Cardiopulmonary Support for Lung Transplantation
정희석¹, 이창영¹, 유우식¹, 함석진², 이진구¹, 백효채¹
연세대학교 의과대학 세브란스병원 흉부외과학교실¹, 연세대학교 의과대학 강남세브란스병원 흉부외과학교실²
Background : Cardiopulmonary bypass (CPB) has been frequently used during lung transplantation because of hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) support has been attempted as an alternative to conventional CPB in the intra-operative support. We changed our policies for intra-operative support from CPB into ECMO and compared early postoperative outcomes and operative parameters for ECMO versus CPB in patients undergoing lung transplantation.
Methods : Between January 2010 and July 2014, 69 patients received lung transplants with 53 patients requiring cardiopulmonary support (CPB group, n=26; ECMO group, n=27) in our institution. We evaluated bleeding complication, perioperative transfusion, bleeding complication, graft rejection and survival in these two groups.
Results : There is no statistical difference between two groups in patient demographics including sex, age, ABO type, NYHA functional class, waiting time, lung function and preoperative ventilator care or ECMO support. Although the amount of blood loss (633.3 ± 1003.7 vs 4177.8 ± 4347.2; P=0.001) during transplantation is more in ECMO group than CPB group, the operation time and blood product transfusion is not significantly different between two groups. Post-operatively, the CPB group received more transfusions of red blood cell (11.5 ± 9.7 vs 7.6 ± 8.1 U), fresh frozen plasma (14.0 ± 5.9 vs 8.6 ± 7.5 U), and platelet concentrate (27.6 ± 14.3 vs 16.5 ± 11.7 U) for the first 48 hours, but showed no statistically significant differences. Postoperative outcomes including re-operation for bleeding, the need for hemodialysis, new postoperative ECMO support, and the rate of graft rejection were no differences significantly between two groups, either. In-hospital mortality and 90 day mortality occurred less frequently in ECMO group with statistical significance (Table 1.)
Conclusion : In this study, early outcomes of ECMO were comparable to those of CPB during lung transplantation. Through these results, we could ascertain safe transitions from CPB into ECMO for intra-operative support during lung transplantation.
Methods : Between January 2010 and July 2014, 69 patients received lung transplants with 53 patients requiring cardiopulmonary support (CPB group, n=26; ECMO group, n=27) in our institution. We evaluated bleeding complication, perioperative transfusion, bleeding complication, graft rejection and survival in these two groups.
Results : There is no statistical difference between two groups in patient demographics including sex, age, ABO type, NYHA functional class, waiting time, lung function and preoperative ventilator care or ECMO support. Although the amount of blood loss (633.3 ± 1003.7 vs 4177.8 ± 4347.2; P=0.001) during transplantation is more in ECMO group than CPB group, the operation time and blood product transfusion is not significantly different between two groups. Post-operatively, the CPB group received more transfusions of red blood cell (11.5 ± 9.7 vs 7.6 ± 8.1 U), fresh frozen plasma (14.0 ± 5.9 vs 8.6 ± 7.5 U), and platelet concentrate (27.6 ± 14.3 vs 16.5 ± 11.7 U) for the first 48 hours, but showed no statistically significant differences. Postoperative outcomes including re-operation for bleeding, the need for hemodialysis, new postoperative ECMO support, and the rate of graft rejection were no differences significantly between two groups, either. In-hospital mortality and 90 day mortality occurred less frequently in ECMO group with statistical significance (Table 1.)
Conclusion : In this study, early outcomes of ECMO were comparable to those of CPB during lung transplantation. Through these results, we could ascertain safe transitions from CPB into ECMO for intra-operative support during lung transplantation.
책임저자: 백효채
연세대학교 의과대학 세브란스병원 흉부외과학교실
연락처 : 백효채, Tel: 02-2228-2142 , E-mail : hcpaik@yuhs.ac
