Application Of Extracorporeal Membrane Oxygenation Combined With Other Artificial Life Support Devices In The Treatment Of Critically Ill Patients

ObjectiveTo summarize and analyze the early outcome of 67 consecutive extracorporeal membrance oxygenation(ECMO)cases performed in Fuwai Hospital,and to interrogate the effection of combining extra-corporeal membrance oxygenation(ECMO)with intra-aortic balloon pump(IABP)on the treatment of critical adult patient.MethodsWe retrospectively analyzed 67 adult patients who received ECMO treatment from January 2010 to December 2014,The patients were divided into simple ECMO group and ECMO plus IABP group according to whether the patients received IABP treatment,then we compared the clinical prognosis between the two groups.ResultsThere are 42 patients in the simple ECMO group,the average age is 45.69± 16.96 years.25 patients are in the ECMO plus IABP group,the average age is 51.44±10.67 years.the duration time of ECMO is 110.43±61.04 hours in the simple ECMO group,the ICU time is 326(193-714)hours,the ventilation time is 252(125-445)hours,16 patients died,the mortality is 38.1%;In the ECMO plus IABP group,the duration time of ECMO is 126.02±57.04 hours,the ICU time is 253(140-486)hours,the ventilation time is 202(104-282)hours,12 patients died,the mortality is 48%.There are no statistical difference in ECMO time,ICU time,ventilator time and mortality in two groups.2 patients of the simple ECMO group hemolysis,7 patients of the ECMO plus IABP group hemolysis.The incidence of hemolysis increased in ECMO combined with IABP group.There is statistical difference between two groups(P=0.011).There are no statistical difference between two groups in other complications such as bleeding,infection,thrombus,limb ischemia,MODS,DIC.In the input of the blood productions,the simple ECMO group input red blood cells 27.43±22.26 units,plasma 3380.48±2934.77 ml,and the platelet 6(2-8)units;The red blood cells input of the ECMO plus IABP group is 29.36±31.52 units,as the plasma 3443.60±3428.39 ml,and the platelet 5(3-10)units.There are no statistical difference between two groups.The serum CRE and BUN of the ECMO combined IABP group is lower 12 hours after ECMO than simple ECMO group(137.29±34.78 VS 170.97±67.78;8.31 ± 3.32 VS 12.15±5.52).There is statistical difference between two groups(P=0.031;P=0.004).12 patients died in the ECMO combined IABP group,the IABP time and the ICU time is short than in simple ECMO group,there is statistical difference between two groups(P=0.006;P<0.001).The incidence of limb ischemia is high in ECMO plus IABP group,there are statistical difference between two groups(P=0.015).ConclusionECMO combined with IABP treatment does not increase mortality in patients,it may increase the incidence of hemolysis.ObjectiveRetrospectively summarized and analyzed the early outcome of 67 consecutive extracorporeal membrance oxygenation(ECMO)cases performed in Fuwai Hospital,and discuss the effection of combining extra-corporeal membrance oxygenation(ECMO)with continuous renal replacement therapy(CRRT)for the treatment of critical adult patient.MethodsWe retrospectively analyzed 67 adult patients who received ECMO treatment from January 2010 to December 2014,divided them into simple ECMO group and ECMO combined with CRRT group according to whether the patients received CRRT treatment,and compared the clinical prognosis between the two groups.Then we divide the patients of the ECMO combined CRRT group into death group and survival group,and compare the ECMO time,ICU time,ventilation time,complications,and blood product input.We also compare electrolyte concentration and renal function before and after the CRRT.ResultsThere are 35 patients in the simple ECMO group,the average age is 46.69± 14.30 years.the duration time of ECMO is 109.44±60.63 hours in the simple ECMO group,the ICU time is 288(198-474)hours,the ventilation time is 197(119-325)hours,10 patients died,the mortality is 28.6%32 patients are in the ECMO combined CRRT group,the average age is 49.09±16.06 years.the duration time of ECMO is 123.69±58.55 hours in the ECMO combined CRRT group,the ICU time is 282(158-668)hours,the ventilation time is 241(141-529)hours,18 patients died,the mortality is 56.2%.The mortality of ECMO combined CRRT group is high,there is statistical difference between two groups(P=0.022).The incidence of MODS is high in ECMO combined CRRT group,there is statistical difference between two groups(P=0.048).the simple ECMO group input red blood cells 14(5-37)units,The red blood cells input of the ECMO combined CRRT group is 29(18-37)units,There is statistical difference between two groups(P=0.025).After ECMO treatment,the BUN of ECMO combined CRRT group is lower than that in simple ECMO group,there is statistical difference between two groups(P=0.014).There are 18 patients died,14 patients survival in the ECMO combined CRRT group,the ICU time,ventilation time of the survival group is long than in died group,there is statistical difference between two groups(P<0.001,P=0.047).The incidence of MODS is high in the died group,there is statistical difference between two groups(P=0.024).The serum sodium level is lower after CRRT than before,there is statistical difference between two groups(P<0.001).ConclusionThe mortality and complications of ECMO combined CRRT is high,and the red blood cells input is high in ECMO combined CRRT group.