초록접수 현황
| 20F-110 | 구연 발표 |
Association between cumulative fluid balance and outcomes in acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation
Jun Hee Lee, MD, Jong Yun Won, MD, Younggi Jung, MD, Ji Eon Kim, MD, Hee Jung Kim MD, PhD, Jae Ho Chung, MD, PhD, Jae Seung Jung, MD, PhD, Ho Sung Son, MD, PhD
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Purpose : Extracorporeal membrane oxygenation(ECMO) has become accepted as a life-saving procedure for patients with severe acute respiratory distress syndrome (ARDS). Restrictive fluid therapy in ARDS decreases mortality and shortens the length of ICU-stay. This study aimed to analyze the relationship between fluid balance and outcomes in ARDS patients treated with ECMO.
Methods : We retrospectively analyzed the data of patients with adult ARDS who received ECMO more than 48 hours between December 2009 and December 2019 in Korea University Anam Hospital. The daily fluid balance was the daily sum of all intakes and outputs. Cumulative fluid balance was calculated the sum of total fluid accumulation during the first 7 days from ECMO initiation. Primary endpoint was 28-day mortality.
Results : A total of 74 patients were divided into survivor (n = 33) and non-survivor (n = 41) groups on the basis of the 28-day survival. No statistically significant differences were observed in patient characteristics between the both groups, except for ECMO duration and hospital length of stay. Non-survivors showed a significantly higher cumulative fluid balance at 1,3,7 days (p = 0.045, p = 0.015, and p = 0.030, respectively). Multivariate Cox regression analysis revealed a relationship between cumulative fluid balance on day 3and 28-day mortality (HR : 2.584, 95% CI: 1.006 – 6.640, p = 0.049)
Conclusion : In adult patients with ARDS treated with ECMO, a higher positive cumulative fluid balance on day 3 is associated with increased 28-day mortality. Cumulative fluid balance may be an effective predictive factor of survival.
Methods : We retrospectively analyzed the data of patients with adult ARDS who received ECMO more than 48 hours between December 2009 and December 2019 in Korea University Anam Hospital. The daily fluid balance was the daily sum of all intakes and outputs. Cumulative fluid balance was calculated the sum of total fluid accumulation during the first 7 days from ECMO initiation. Primary endpoint was 28-day mortality.
Results : A total of 74 patients were divided into survivor (n = 33) and non-survivor (n = 41) groups on the basis of the 28-day survival. No statistically significant differences were observed in patient characteristics between the both groups, except for ECMO duration and hospital length of stay. Non-survivors showed a significantly higher cumulative fluid balance at 1,3,7 days (p = 0.045, p = 0.015, and p = 0.030, respectively). Multivariate Cox regression analysis revealed a relationship between cumulative fluid balance on day 3and 28-day mortality (HR : 2.584, 95% CI: 1.006 – 6.640, p = 0.049)
Conclusion : In adult patients with ARDS treated with ECMO, a higher positive cumulative fluid balance on day 3 is associated with increased 28-day mortality. Cumulative fluid balance may be an effective predictive factor of survival.
첨부파일 : table2.docx
책임저자: Ho Sung Son
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
발표자: Jun Hee Lee, E-mail : lee2632@naver.com