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

Am J Surg. 2010 May;199(5):669-75. doi: 10.1016/j.amjsurg.2010.01.018.

Abstract

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 >or=21 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.

MeSH terms

  • Adult
  • Aged
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Heart Failure / etiology
  • Heart Failure / mortality
  • Heart Failure / therapy*
  • Hematologic Neoplasms / complications
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Life Support Care / methods
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / diagnosis
  • Neoplasms / therapy
  • Prognosis
  • Registries
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / therapy*
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome