Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation

Abstract Background As lung transplantation (LTx) is becoming a standard treatment for end-stage lung disease, the use of bridging with extracorporeal membrane oxygenation (ECMO) is increasing. We examined the clinical impact of being awake during ECMO as bridging therapy in patients awaiting LTx. M...

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Autores principales:	Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Extracorporeal membrane oxygenation Lung transplantation Critical care Respiratory function tests Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/6ff5a0cee5a8489186f71dcdd5b1206a
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spelling	oai:doaj.org-article:6ff5a0cee5a8489186f71dcdd5b1206a2021-11-28T12:29:14ZLong- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation10.1186/s12931-021-01905-71465-993Xhttps://doaj.org/article/6ff5a0cee5a8489186f71dcdd5b1206a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12931-021-01905-7https://doaj.org/toc/1465-993XAbstract Background As lung transplantation (LTx) is becoming a standard treatment for end-stage lung disease, the use of bridging with extracorporeal membrane oxygenation (ECMO) is increasing. We examined the clinical impact of being awake during ECMO as bridging therapy in patients awaiting LTx. Methods In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019; 64 patients received ECMO support while awaiting LTx. We divided into awake and non-awake groups and compared. Results Twenty-five patients (39.1%) were awake, and 39 (61.0%) were non-awake. The median age of awake patients was 59.0 (interquartile range, 52.5–63.0) years, and 80% of the group was men. The awake group had better post-operative outcomes than the non-awake group: statistically shorter post-operative intensive care unit length of stay [awake vs. non-awake, 6 (4–8.5) vs. 18 (11–36), p < 0.001], longer ventilator free days [awake vs. non-awake, 24 (17–26) vs. 0 (0–15), p < 0.001], and higher gait ability after LTx (awake vs. non-awake, 92% vs. 59%, p = 0.004), leading to higher 6-month and 1-year lung function (forced expiratory volume in 1 s: awake vs. non-awake, 6-month, 77.5% vs. 61%, p = 0.004, 1-year, 75% vs. 57%, p = 0.013). Furthermore, the awake group had significantly lower 6-month and 1-year mortality rates than the non-awake group (6-month 12% vs. 38.5%, p = 0.022, 1-year 24% vs. 53.8%, p = 0.018). Conclusions In patients with end-stage lung disease, considering the long-term and short-term impacts, the awake ECMO strategy could be useful compared with the non-awake ECMO strategy.Nam Eun KimAla WooSong Yee KimAh Young LeemYoungmok ParkSe Hyun KwakSeung Hyun YongKyungsoo ChungMoo Suk ParkYoung Sam KimHa Eun KimJin Gu LeeHyo Chae PaikSu Hwan LeeBMCarticleExtracorporeal membrane oxygenationLung transplantationCritical careRespiratory function testsDiseases of the respiratory systemRC705-779ENRespiratory Research, Vol 22, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Extracorporeal membrane oxygenation Lung transplantation Critical care Respiratory function tests Diseases of the respiratory system RC705-779
spellingShingle	Extracorporeal membrane oxygenation Lung transplantation Critical care Respiratory function tests Diseases of the respiratory system RC705-779 Nam Eun Kim Ala Woo Song Yee Kim Ah Young Leem Youngmok Park Se Hyun Kwak Seung Hyun Yong Kyungsoo Chung Moo Suk Park Young Sam Kim Ha Eun Kim Jin Gu Lee Hyo Chae Paik Su Hwan Lee Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
description	Abstract Background As lung transplantation (LTx) is becoming a standard treatment for end-stage lung disease, the use of bridging with extracorporeal membrane oxygenation (ECMO) is increasing. We examined the clinical impact of being awake during ECMO as bridging therapy in patients awaiting LTx. Methods In this single-center study, we retrospectively reviewed 241 consecutive LTx patients between October 2012 and March 2019; 64 patients received ECMO support while awaiting LTx. We divided into awake and non-awake groups and compared. Results Twenty-five patients (39.1%) were awake, and 39 (61.0%) were non-awake. The median age of awake patients was 59.0 (interquartile range, 52.5–63.0) years, and 80% of the group was men. The awake group had better post-operative outcomes than the non-awake group: statistically shorter post-operative intensive care unit length of stay [awake vs. non-awake, 6 (4–8.5) vs. 18 (11–36), p < 0.001], longer ventilator free days [awake vs. non-awake, 24 (17–26) vs. 0 (0–15), p < 0.001], and higher gait ability after LTx (awake vs. non-awake, 92% vs. 59%, p = 0.004), leading to higher 6-month and 1-year lung function (forced expiratory volume in 1 s: awake vs. non-awake, 6-month, 77.5% vs. 61%, p = 0.004, 1-year, 75% vs. 57%, p = 0.013). Furthermore, the awake group had significantly lower 6-month and 1-year mortality rates than the non-awake group (6-month 12% vs. 38.5%, p = 0.022, 1-year 24% vs. 53.8%, p = 0.018). Conclusions In patients with end-stage lung disease, considering the long-term and short-term impacts, the awake ECMO strategy could be useful compared with the non-awake ECMO strategy.
format	article
author	Nam Eun Kim Ala Woo Song Yee Kim Ah Young Leem Youngmok Park Se Hyun Kwak Seung Hyun Yong Kyungsoo Chung Moo Suk Park Young Sam Kim Ha Eun Kim Jin Gu Lee Hyo Chae Paik Su Hwan Lee
author_facet	Nam Eun Kim Ala Woo Song Yee Kim Ah Young Leem Youngmok Park Se Hyun Kwak Seung Hyun Yong Kyungsoo Chung Moo Suk Park Young Sam Kim Ha Eun Kim Jin Gu Lee Hyo Chae Paik Su Hwan Lee
author_sort	Nam Eun Kim
title	Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title_short	Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title_full	Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title_fullStr	Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title_full_unstemmed	Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title_sort	long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/6ff5a0cee5a8489186f71dcdd5b1206a
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Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation

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