Outcomes of the NHS England National Extracorporeal Membrane Oxygenation Service for adults with respiratory failure: a multicentre observational cohort study.
ARDS
ECMO
National Health Service
extracorporeal membrane oxygenation
mechanical ventilation
respiratory failure
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
28
04
2020
revised:
26
05
2020
accepted:
27
05
2020
pubmed:
2
8
2020
medline:
17
9
2020
entrez:
2
8
2020
Statut:
ppublish
Résumé
Extracorporeal membrane oxygenation (ECMO) is increasingly used to support adults with severe respiratory failure refractory to conventional measures. In 2011, NHS England commissioned a national service to provide ECMO to adults with refractory acute respiratory failure. Our aims were to characterise the patients admitted to the service, report their outcomes, and highlight characteristics potentially associated with survival. An observational cohort study was conducted of all patients treated by the NHS England commissioned ECMO service between December 1, 2011 and December 31, 2017. Analysis was conducted according to a prespecified protocol (NCT: 03979222). Data are presented as median [inter-quartile range, IQR]. A total of 1205 patients were supported with ECMO during the study period; the majority (n=1150; 95%) had veno-venous ECMO alone. The survival rate at ECMO ICU discharge was 74% (n=887). Survivors had a lower median age (43 yr [32-52]), compared with non-survivors (49 y [39-60]). Increased severity of hypoxaemia at time of decision-to-cannulate was associated with a lower probability of survival: survivors had a median Sao A national ECMO service can achieve good short-term outcomes for patients with undifferentiated respiratory failure refractory to conventional management. NCT03979222.
Sections du résumé
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) is increasingly used to support adults with severe respiratory failure refractory to conventional measures. In 2011, NHS England commissioned a national service to provide ECMO to adults with refractory acute respiratory failure. Our aims were to characterise the patients admitted to the service, report their outcomes, and highlight characteristics potentially associated with survival.
METHODS
An observational cohort study was conducted of all patients treated by the NHS England commissioned ECMO service between December 1, 2011 and December 31, 2017. Analysis was conducted according to a prespecified protocol (NCT: 03979222). Data are presented as median [inter-quartile range, IQR].
RESULTS
A total of 1205 patients were supported with ECMO during the study period; the majority (n=1150; 95%) had veno-venous ECMO alone. The survival rate at ECMO ICU discharge was 74% (n=887). Survivors had a lower median age (43 yr [32-52]), compared with non-survivors (49 y [39-60]). Increased severity of hypoxaemia at time of decision-to-cannulate was associated with a lower probability of survival: survivors had a median Sao
CONCLUSION
A national ECMO service can achieve good short-term outcomes for patients with undifferentiated respiratory failure refractory to conventional management.
CLINICAL TRIAL REGISTRATION
NCT03979222.
Identifiants
pubmed: 32736826
pii: S0007-0912(20)30490-6
doi: 10.1016/j.bja.2020.05.065
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03979222']
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
259-266Subventions
Organisme : Medical Research Council
ID : MC_UU_00002/15
Pays : United Kingdom
Informations de copyright
Copyright © 2020 British Journal of Anaesthesia. All rights reserved.