Short-term outcome of veno-venous extracorporeal membrane oxygenation in patients of acute respiratory distress syndrome presenting at a tertiary care centre - An observational study.

Abstract

Background and objective: Acute respiratory distress syndrome (ARDS) is a severe and potentially fatal condition characterised by inflammation and damage to the lungs. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is a form of life support that can be used in the management of ARDS. This study was done to evaluate the short-term outcome of VV ECMO in patients of ARDS presenting at our institute.

Materials: This ambispective observational study was carried out on patients with severe ARDS on VV ECMO admitted to the intensive care unit (ICU). Parameters studied included duration of pre-ECMO and total duration of mechanical ventilation, duration of ECMO, length of stay in ICU, length of hospital stay, and in-hospital mortality from the case records. The APACHE II, SOFA, and Murray scores were also recorded.

Results: The mean age of the ARDS patients in our study was 48.70 ± 12.06 years. Out of 70 study patients, 41 were male and 29 were female. The most common underlying causes of ARDS requiring VV ECMO were pneumonia and sepsis. The primary indication for ECMO initiation in all patients was refractory hypoxemia despite optimal conventional ventilation. The rate of mortality was significantly higher in patients with pneumonia (44.7%) and sepsis (44.4%). The mean duration of mechanical ventilation and the mean duration of ECMO were 21.86 ± 13.19 days and 16.35 ± 10.11 days, respectively. The mean duration of ICU and hospital stay in our study was 23.26 ± 12.25 days and 27.33 ± 14.44 days, respectively. The proportion of survivors (58.6%) was higher than that of non-survivors (41.4%).

Conclusion: VV ECMO can be used as a treatment option for patients with severe ARDS who are failing conventional mechanical ventilation.