• Eur J Cardiothorac Surg · Apr 2020

    Clinical outcomes of immunocompromised patients on extracorporeal membrane oxygenation support for severe acute respiratory failure.

    • Soo Jin Na, So Hee Park, Sang-Bum Hong, Woo Hyun Cho, Sang-Min Lee, Young-Jae Cho, Sunghoon Park, So-My Koo, Seung Yong Park, Youjin Chang, Byung Ju Kang, Jung-Hyun Kim, Jin Young Oh, Jae-Seung Jung, Jung-Wan Yoo, Yun Su Sim, and Kyeongman Jeon.
    • Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    • Eur J Cardiothorac Surg. 2020 Apr 1; 57 (4): 788-795.

    ObjectivesThere are limited data regarding extracorporeal membrane oxygenation (ECMO) support in immunocompromised patients, despite an increase in ECMO use in patients with respiratory failure. The aim of this study was to investigate the clinical characteristics and outcomes of immunocompromised patients requiring ECMO support for severe acute respiratory failure.MethodsBetween January 2012 and December 2015, all consecutive adult patients with severe acute respiratory failure who underwent ECMO for respiratory support at 16 tertiary or university-affiliated hospitals in South Korea were enrolled retrospectively. The patients were divided into 2 groups based on the immunocompromised status at the time of ECMO initiation. In-hospital and 6-month mortalities were compared between the 2 groups. In addition, association of immunocompromised status with 6-month mortality was evaluated with logistic regression analysis.ResultsAmong 461 patients, 118 (25.6%) were immunocompromised. Immunocompromised patients were younger and had lower haemoglobin and platelet counts than immunocompetent patients. Ventilatory parameters and the use of adjunctive/rescue therapies were similar between the 2 groups, but prone positioning was more commonly used in immunocompetent patients. Successful weaning rates from ECMO (46.6% vs 58.9%; P = 0.021) was lower and hospital mortality (66.1% vs 59.8%; P = 0.22) was higher in immunocompromised patients. In addition, immunocompromised status was associated with higher 6-month mortality (74.6% vs 64.7%, adjusted odds ratio 2.10, 95% confidence interval 1.02-4.35; P = 0.045).ConclusionsImmunocompromised patients treated with ECMO support for severe acute respiratory failure had poorer short- and long-term prognoses than did immunocompetent patients.© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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