Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience

被引:38
作者
Gow, Kenneth W. [1 ]
Lao, Oliver B. [2 ]
Leong, Traci [3 ]
Fortenberry, James D. [4 ,5 ]
机构
[1] Univ Washington, Dept Surg, Seattle, WA 98195 USA
[2] Univ Washington, Div Pediat Gen & Thorac Surg, Seattle, WA 98195 USA
[3] Emory Univ, Sch Publ Hlth, Dept Biostat & Bioinformat, Atlanta, GA USA
[4] Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA
[5] Childrens Healthcare Atlanta Egleston, Ctr ECMO & Adv Technol, Atlanta, GA USA
关键词
Extracorporeal; Life support; Membrane; Oxygenation; Malignancy; Cancer; Adults; STEM-CELL TRANSPLANTATION; INTENSIVE-CARE UNIT; MEMBRANE-OXYGENATION; DISTRESS-SYNDROME; CANCER-PATIENTS; HEMATOLOGICAL MALIGNANCY; PROGNOSTIC-FACTORS; ORGAN FAILURE; VENTILATION; MORTALITY;
D O I
10.1016/j.amjsurg.2010.01.018
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy. METHODS: The Extracorporeal Life Support Organization Registry was queried for patients aged years with diagnoses of malignancy or hematopoietic stem cell transplantation. RESULTS: Seventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation. Patients required ECLS primarily for pulmonary support (n = 54). The median duration of ECLS was 4.1 days. Overall, 44 patients (61%) died on ECLS, 23 (32%) survived to hospital discharge, and 5 (7%) survived ECLS but died before discharge. Risk factors for death include pulmonary support as reason for ECLS, impaired lung function before ECLS, and development of infection. CONCLUSIONS: Adults with cancer can be offered ECLS with a small but real expectation for survival. Impaired pulmonary status and the development of infections are associated with death. (C) 2010 Elsevier Inc. All rights reserved.
引用
收藏
页码:669 / 675
页数:7
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