Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants
Background Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperati...
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doaj-dbc8ffe8f0f144b8a0a75af913ecba482020-11-24T23:16:18ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702383-48892015-11-0130428629410.4266/kjccm.2015.30.4.28644Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung TransplantsHa Yeon Kim0Sungwon Na1Hyo Chae Paik2Jonglin Ha3Jeongmin Kim4 Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, KoreaBackground Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO. Methods We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups. Results There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 – 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 – 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups. Conclusions The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients.http://kjccm.org/upload/pdf/kjccm-2015-30-4-286.pdfextracorporeal membrane oxygenationlung transplantationperioperativerisk factorweaning |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ha Yeon Kim Sungwon Na Hyo Chae Paik Jonglin Ha Jeongmin Kim |
spellingShingle |
Ha Yeon Kim Sungwon Na Hyo Chae Paik Jonglin Ha Jeongmin Kim Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants Korean Journal of Critical Care Medicine extracorporeal membrane oxygenation lung transplantation perioperative risk factor weaning |
author_facet |
Ha Yeon Kim Sungwon Na Hyo Chae Paik Jonglin Ha Jeongmin Kim |
author_sort |
Ha Yeon Kim |
title |
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants |
title_short |
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants |
title_full |
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants |
title_fullStr |
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants |
title_full_unstemmed |
Perioperative Risk Factors associated with Immediate Postoperative Extracorporeal Membrane Oxygenation in Lung Transplants |
title_sort |
perioperative risk factors associated with immediate postoperative extracorporeal membrane oxygenation in lung transplants |
publisher |
Korean Society of Critical Care Medicine |
series |
Korean Journal of Critical Care Medicine |
issn |
2383-4870 2383-4889 |
publishDate |
2015-11-01 |
description |
Background Extracorporeal membrane oxygenation (ECMO) is administered for a few days after lung transplantation (LTx) in recipients who are expected to have early graft dysfunction. Despite its life-saving potential, immediate postoperative ECMO has life-threatening complications such as postoperative bleeding. We investigated the risk factors related to the use of immediate postoperative ECMO. Methods We retrospectively reviewed the records of 60 LTx patients who were at our institution from October 2012 to May 2015. Perioperative variables associated with postoperative ECMO were compared between the two groups. Results There were 26 patients who received postoperative ECMO (ECMO group) and 34 patients who did not (control group). Multivariate regression analysis revealed preoperative ECMO (odds ratio [OR] 12.55, 95% confidence intervals [CI] 1.34 – 117.24, p = 0.027) and lower peripheral pulse oxymetry saturation (SpO2) at the end of surgery (OR 0.71, 95% CI 0.54 – 0.95, p = 0.019) were independent risk factors for postoperative ECMO in LTx patients. The incidences of complications, such as re-operation, tracheostomy, renal failure and postoperative atrial fibrillation, were higher in the ECMO group. There was no difference in the duration of postoperative intensive care unit stay or postoperative 30-day mortality between the two groups. Conclusions The preoperative ECMO and lower SpO2 at the end of surgery were associated with postoperative ECMO. Further, postoperative adverse events were higher in the ECMO group compared with the control group. This study suggests that determination of postoperative ECMO requires careful consideration because of the risks of postoperative ECMO in LTx patients. |
topic |
extracorporeal membrane oxygenation lung transplantation perioperative risk factor weaning |
url |
http://kjccm.org/upload/pdf/kjccm-2015-30-4-286.pdf |
work_keys_str_mv |
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