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

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:...

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Autores principales: Kim, Nam Eun, Woo, Ala, Kim, Song Yee, Leem, Ah Young, Park, Youngmok, Kwak, Se Hyun, Yong, Seung Hyun, Chung, Kyungsoo, Park, Moo Suk, Kim, Young Sam, Kim, Ha Eun, Lee, Jin Gu, Paik, Hyo Chae, Lee, Su Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627606/
https://www.ncbi.nlm.nih.gov/pubmed/34839821
http://dx.doi.org/10.1186/s12931-021-01905-7
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author Kim, Nam Eun
Woo, Ala
Kim, Song Yee
Leem, Ah Young
Park, Youngmok
Kwak, Se Hyun
Yong, Seung Hyun
Chung, Kyungsoo
Park, Moo Suk
Kim, Young Sam
Kim, Ha Eun
Lee, Jin Gu
Paik, Hyo Chae
Lee, Su Hwan
author_facet Kim, Nam Eun
Woo, Ala
Kim, Song Yee
Leem, Ah Young
Park, Youngmok
Kwak, Se Hyun
Yong, Seung Hyun
Chung, Kyungsoo
Park, Moo Suk
Kim, Young Sam
Kim, Ha Eun
Lee, Jin Gu
Paik, Hyo Chae
Lee, Su Hwan
author_sort Kim, Nam Eun
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-021-01905-7.
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spelling pubmed-86276062021-11-30 Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation Kim, Nam Eun Woo, Ala Kim, Song Yee Leem, Ah Young Park, Youngmok Kwak, Se Hyun Yong, Seung Hyun Chung, Kyungsoo Park, Moo Suk Kim, Young Sam Kim, Ha Eun Lee, Jin Gu Paik, Hyo Chae Lee, Su Hwan Respir Res Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12931-021-01905-7. BioMed Central 2021-11-28 2021 /pmc/articles/PMC8627606/ /pubmed/34839821 http://dx.doi.org/10.1186/s12931-021-01905-7 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kim, Nam Eun
Woo, Ala
Kim, Song Yee
Leem, Ah Young
Park, Youngmok
Kwak, Se Hyun
Yong, Seung Hyun
Chung, Kyungsoo
Park, Moo Suk
Kim, Young Sam
Kim, Ha Eun
Lee, Jin Gu
Paik, Hyo Chae
Lee, Su Hwan
Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
title 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_short 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
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627606/
https://www.ncbi.nlm.nih.gov/pubmed/34839821
http://dx.doi.org/10.1186/s12931-021-01905-7
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