초록접수 현황
| 16F-011 | 구연 발표 |
Is the Safe to use the ECMO in Acute Respiratory Failure Patients with Intracranial Hemorrhage?
Hyoung Soo Kim¹, Sung Hoon Park², Sang Ook Ha³, Sun Hee Lee¹
¹Department of Thoracic and Cardiovascular Surgery, ²Pulmonary, Allergy and Critical care medicine, ³Emergency Medicine, Sacred Heart Hospital, Hanllym University College of Medicine, Gyeonggi-do, Korea
Background : The aim of this study was to investigate efficacy the safety for using of extracorporeal membrane oxygenation (ECMO) in acute respiratory failure (ARF) patients with intracranial hemorrhage (ICH).
Methods : Between January 2012 and December 2015, 145 patients with acute circulatory and/or respiratory failure underwent ECMO treatment. Of these, 10 patients with ICH with ARF before running ECMO were enrolled. The inclusion criteria for ECMO were based on the lung dysfunction measured with a PaO2/FiO2 ratio<100 for a FiO2 1.0.
Results : Five of the 10 patients were male and the mean age was 46.7±20.9. The types of ICH were six cases of traumatic injury and 4 spontaneous. On admission, the mental status was 2 alert, 1 drowsy, 2 stupor, 2 semi-coma and a coma. Among the 6 cases of traumatic ICH with ARF, 4 were caused by traffic accident, one by crushing injury, and another one by fall down. Among the 4 cases of spontaneous ICH with ARF, 3 were caused by sepsis induced acute lung injury and one by neurogenic pulmonary edema. Before the start of ECMO, the PaO2/FiO2 ratio was 56.5±19.8mmHg. The modes of ECMO were 9 cases of VV ECMO and a VA ECMO. Among the 4 cases of brain surgery, one was performed during VV ECMO. One patients of traumatic lung injury was performed thoracic surgery during VV ECMO. The mean support time of ECMO was 172.0±53.6 hours. All patients were successfully weaned off and 30-day survival rate was 90%. 7 patients discharged from the hospital after a mean 82.0±42.0 hospital day. Cerebral Performance Category grade of discharged patients was 1~2.
Conclusion : Based on our results, using of ECMO could be safe in patients who have a ICH with unresponsive acute respiratory failure that did not respond to conventional therapy.
Methods : Between January 2012 and December 2015, 145 patients with acute circulatory and/or respiratory failure underwent ECMO treatment. Of these, 10 patients with ICH with ARF before running ECMO were enrolled. The inclusion criteria for ECMO were based on the lung dysfunction measured with a PaO2/FiO2 ratio<100 for a FiO2 1.0.
Results : Five of the 10 patients were male and the mean age was 46.7±20.9. The types of ICH were six cases of traumatic injury and 4 spontaneous. On admission, the mental status was 2 alert, 1 drowsy, 2 stupor, 2 semi-coma and a coma. Among the 6 cases of traumatic ICH with ARF, 4 were caused by traffic accident, one by crushing injury, and another one by fall down. Among the 4 cases of spontaneous ICH with ARF, 3 were caused by sepsis induced acute lung injury and one by neurogenic pulmonary edema. Before the start of ECMO, the PaO2/FiO2 ratio was 56.5±19.8mmHg. The modes of ECMO were 9 cases of VV ECMO and a VA ECMO. Among the 4 cases of brain surgery, one was performed during VV ECMO. One patients of traumatic lung injury was performed thoracic surgery during VV ECMO. The mean support time of ECMO was 172.0±53.6 hours. All patients were successfully weaned off and 30-day survival rate was 90%. 7 patients discharged from the hospital after a mean 82.0±42.0 hospital day. Cerebral Performance Category grade of discharged patients was 1~2.
Conclusion : Based on our results, using of ECMO could be safe in patients who have a ICH with unresponsive acute respiratory failure that did not respond to conventional therapy.
책임저자: Hyoung Soo Kim
Department of Thoracic and Cardiovascular Surgery, Sacred Heart Hospital, Hanllym University College of Medicine, Gyeonggi-do, Korea
발표자: Hyoung Soo Kim, E-mail : cskhs99@hallym.or.kr