Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Narm, Kyoung Shik; Suh, Jeewon; Kim, Anes; Lee, Jin Gu; Park, Moo Suk; Kim, Song Yee; Song, Joo Han; Jeong, Su Jin; Paik, Hyo Chae

doi:10.1016/j.athoracsur.2017.07.046

Cited by 14 publications

(8 citation statements)

References 31 publications

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“…Furthermore, graft ischemia time, recipient age, primary indications, preoperative LAS, Pco 2 level, complications, right ventricular function, mechanical ventilation status, surgery time, blood loss, and transfusion were not identified as independent risk factors for ECMO weaning after LTx, which was inconsistent with other studies. Narm et al 16 independent factors related to early ECMO removal at the end of LTx. Baek et al 17 reported that it was more difficult for elderly patients >65 years to take off ECMO in time after LTx.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation

Liu

et al. 2020

Transplantation

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Background. Extracorporeal membrane oxygenation (ECMO) is widely used for cardiopulmonary assistance during lung transplantation (LTx). However, the optimal timing for ECMO removal remains controversial. This study aimed to evaluate the risk factors and early prognosis of delayed withdrawal ECMO after LTx. Methods. Two hundred sixty-seven patients who underwent LTx supported by ECMO were included in this study. Based on whether or not ECMO was completely stopped in the operating room, patients were divided into early ECMO withdrawal group (group E, 107 cases) and delayed withdrawal group (group D, 160 cases). Perioperative data of the donors and recipients, including the suspected risk factors for delayed removal of ECMO, postoperative complications, and hospital survival rate, were retrospectively analyzed. Results. Preoperative New York Heart Association cardiac function for recipients and mechanical ventilation time for donors were independent risk factors for delayed weaning of ECMO in veno-arterial ECMO patients. Compared with group E, the odds of postoperative pulmonary infection, primary graft dysfunction, renal dysfunction, blood transfusion volume, and mechanical ventilation time were significantly higher in group D (all P < 0.05). Delayed withdrawal ECMO was decisive factor for early postoperative death, as the risk of early postoperative death in group D was 1.99 (95% confidence interval, 1.13-3.54) times as that in the group E. Conclusions. During the period of LTx, New York Heart Association grade III/IV for recipients and mechanical ventilation time ≥5 days for donors are suggestive of delayed veno-arterial ECMO removal, and clinicians should minimize the postoperative bypass time of ECMO when conditions permit.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation

Liu

et al. 2020

Transplantation

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“…We suggest antagonizing heparin with halfdose protamine. Recently, Narm et al have shown that increasing donor age, donor PaO 2 and increasing operation duration were independent risk factors of weaning failure from intraoperative ECMO in their experience (62).…”

Section: Ecmo For Intraoperative Supportmentioning

confidence: 96%

Extracorporeal support, during and after lung transplantation: the history of an idea

Ius¹,

Tudorache²,

Warnecke³

2018

J. Thorac. Dis.

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During recent years, continuous technological innovation has provoked an increase of extracorporeal life support (ECLS) use for perioperative cardiopulmonary support in lung transplantation. Initial results were disappointing, due to ECLS-specific complications and high surgical risk of the supported patients. However, the combination of improved patient management, multidisciplinary team work and standardization of ECLS protocols has recently yielded excellent results in several case series from high-volume transplant centres. Therein, it was demonstrated that, although the prevalence of complications remains higher in supported patients, there may be no difference in long-term graft function between supported and non-supported patients. These results are important, because most of the patients who require ECLS support in lung transplantation are young and have no other chance to survive, but to be transplanted. Moreover, there is no device for "bridging to destination" therapy in lung transplantation. Of note, the evidence in favour of ECLS support in lung transplantation was never validated by randomized controlled trials, but by everyday experience at the patient bed-side. Here, we review the state-of-the-art ECLS evidence for intraoperative and postoperative cardiopulmonary support in lung transplantation.

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“…2,46 Other risk factors for PGD include advanced donor age, prolonged donor mechanical ventilation, donor PaO 2 before lung procurement, and prolonged operative time. 47 A summary of studies examining ECMO prolongation into the postoperative period can be found in Table 4.…”

Section: Postoperative Ecmo In Lung Transplantationmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation in Lung Transplantation: Analysis of Techniques and Outcomes

Martin

Jayaraman

Nabzdyk

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

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Risk Factor Analysis for Intraoperative Extracorporeal Membrane Oxygenation Weaning Failure After Lung Transplantation

Abstract: Our results showed that younger donor age, high Pao, and shorter operation time were factors related to successful ECMO weaning in the operating room after LTx.

Cited by 14 publications

References 31 publications

A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation

A Retrospective Analysis for Risk Factors and Early Prognosis of Delayed Withdrawal Extracorporeal Membrane Oxygenation After Lung Transplantation

Extracorporeal support, during and after lung transplantation: the history of an idea

Extracorporeal Membrane Oxygenation in Lung Transplantation: Analysis of Techniques and Outcomes

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