Factors predicting early- and long-term survival in patients undergoing extracorporeal membrane oxygenation (ECMO).

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is an established treatment option in patients with cardiogenic shock and respiratory dysfunction. We assessed outcomes of ECMO, as well as predictors of ECMO weaning and survival, in patients treated in our institution over the past five years.

METHODS: We reviewed the records of 185 patients who received ECMO support for various medical conditions between January 2005 and January 2010. Risk factors for successful weaning, early mortality, and overall survival were investigated.

RESULTS: There were 101 males and 84 females, and the mean age was 56.1 ± 14.7 years. Patients received either venoarterial (n = 137) or veno-veno (n = 48) ECMO. ECMO was instituted in stable patients (n = 40, 21.6%), those in shock (n = 105, 56.8%), or those in cardiac arrest (n = 40, 21.6%). Mean ECMO support lasted 4.7 days and weaning was successful in 68 patients (36.7%), with 38 (20.5%) eventually being discharged from the hospital. Univariate analysis showed hemodynamic status at insertion (p = 0.05) including intra-aortic balloon pump usage to significantly influence successful weaning, whereas the duration of ECMO was strongly associated with overall survival (p = 0.05).

CONCLUSIONS: Early ECMO application before catastrophic clinical deterioration and weaning as soon as possible may enhance overall survival.