초록접수 현황
| 19F-090 | 구연 발표 |
Factors for Affecting Outcomes of Venovenous Extracorporeal Membrane Oxygenation for Traumatic Patients
Seon Hee Kim¹, Seunghwan Song², Up Huh², Chan Kyu Lee¹, Hyn Min Cho¹
¹Departments of Trauma Surgery, Pusan National University Hospital Trauma Center, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Republic of Korea, ²Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Republic of Korea
Purpose : Although venovenous extracorporeal membrane oxygenation (VV-ECMO) is an established salvage therapy for adult respiratory distress syndrome (ARDS), the use of ECMO is still controversial in adult trauma patients. The purpose of this study is to investigate the affecting factors for outcomes of ECMO in patients with posttraumatic ARDS.
Methods : From 2015 to 2017, 23 trauma patients (median age: 47 years, 20 males, median injury severity score: 29) received VV ECMO in a level I trauma center were enrolled in this retrospective study. Demographics, injury-specific data, ECMO data were collected for outcome analyses. We analyzed the association between hospital mortality, ECMO weaning failure and each injury severity scoring system.
Results : Nineteen patients (82.6%) were weaned off ECMO, and of these patients sixteen survived. Overall hospital mortality rate was 30.4%. In univariate analysis, Revised trauma score (RTS) was the only statistically significant factor associated with ECMO weaning failure (Hazard ratio[HR]:0.429, 95% confidence interval[CI]:0.185-0.99,p=0.05). Trauma and injury severity score (TRISS) was found to be high in the survivor and weaning success group, but it was not statistically significant (p=0.07 and p=0.06, respectively). In prediction of ECMO weaning failure, RTS and TRISS were statistically significant, ≤0.35 and ≤3.56, 0.001 and 0.00, cut-off value and p value, respectively. TRISS and Respiratory extracorporeal membrane oxygenation survival prediction score (RESP) were associated with mortality, ≤0.465 and ≤3, 0.02 and 0.035, cut-off value and p value, respectively.
Conclusion : VV ECMO can be effective rescue treatment for posttraumatic ARDS. TRISS seems to be useful in predicting the prognosis of patients.
Methods : From 2015 to 2017, 23 trauma patients (median age: 47 years, 20 males, median injury severity score: 29) received VV ECMO in a level I trauma center were enrolled in this retrospective study. Demographics, injury-specific data, ECMO data were collected for outcome analyses. We analyzed the association between hospital mortality, ECMO weaning failure and each injury severity scoring system.
Results : Nineteen patients (82.6%) were weaned off ECMO, and of these patients sixteen survived. Overall hospital mortality rate was 30.4%. In univariate analysis, Revised trauma score (RTS) was the only statistically significant factor associated with ECMO weaning failure (Hazard ratio[HR]:0.429, 95% confidence interval[CI]:0.185-0.99,p=0.05). Trauma and injury severity score (TRISS) was found to be high in the survivor and weaning success group, but it was not statistically significant (p=0.07 and p=0.06, respectively). In prediction of ECMO weaning failure, RTS and TRISS were statistically significant, ≤0.35 and ≤3.56, 0.001 and 0.00, cut-off value and p value, respectively. TRISS and Respiratory extracorporeal membrane oxygenation survival prediction score (RESP) were associated with mortality, ≤0.465 and ≤3, 0.02 and 0.035, cut-off value and p value, respectively.
Conclusion : VV ECMO can be effective rescue treatment for posttraumatic ARDS. TRISS seems to be useful in predicting the prognosis of patients.
첨부파일 : Tables and figures_01.docx
책임저자: Seunghwan Song
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Biomedical Research Institute, Pusan National University College of Medicine, Busan, Republic of Korea
발표자: Seon Hee Kim, E-mail : ksh810427@naver.com