Extracorporeal membrane oxygenation in adult patients with severe acute respiratory failure

Acta Anaesthesiol Scand. 2013 Mar;57(3):303-11. doi: 10.1111/aas.12050. Epub 2012 Dec 28.


Background: A group of patients with severe acute respiratory distress syndrome (ARDS) is resistant to advanced respiratory therapy. In these patients, extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy. This study presents 14 years of experience from a Scandinavian ECMO centre. The aim of the study is to present outcome results and to investigate whether or not simplified acute physiology score II (SAPS-II), sequential organ failure assessment (SOFA) and/or Murray scores can be used to predict patients' outcome.

Methods: In a prospective observational study, we collected data from ECMO patients from January 1997 to March 2011. The treatment was based mainly on venous-venous ECMO and centrifugal pumps. Patients were retrieved from Denmark plus a number from Sweden and Norway. The inclusion criteria were the classical criteria until November 2009 (n = 100), after which the new Extracorporeal Life Support Organisation criteria (n = 24) were used.

Results: One hundred and twenty-four patients were enrolled with median age 45 (range 16-67) years. The median Murray score was 3.7 (2.5-4.0). One hundred and six (85%) of the patients were retrieved from referring hospitals on ECMO. The median duration of the ECMO runs was 215 (1-578) h. Ninety-seven (78%) of the patients could be weaned from ECMO. A total of 88 (71%) were discharged alive to the referring hospitals. High SAPS-II, SOFA and Murray scores were associated with a high mortality.

Conclusion: Patients with severe ARDS have a favourable outcome when treated with ECMO and when an ECMO retrieval team establishes the ECMO treatment at the referring hospital. SAPS-II, SOFA and Murray scores predicted the outcome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Critical Care
  • Databases, Factual
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / instrumentation
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Respiratory Distress Syndrome / therapy*
  • Retrospective Studies
  • Treatment Outcome
  • Ventilator Weaning
  • Young Adult