Key result
Long-term ECMO support (≥28 days) resulted in similar hospital survival compared to short-term ECMO (<28 days) (50% vs 54%).
Why the study?
While the duration of ECMO treatments is increasing, data regarding prolonged ECMO support remain limited.
Does long-term ECMO support (≥28 days) compared to short-term ECMO support (<28 days) affect hospital survival in patients with ARDS or bridging to lung transplantation?
Cohort (n=55)
Does long-term ECMO support (≥28 days) compared to short-term ECMO support (<28 days) affect hospital survival in patients with ARDS or bridging to lung transplantation?
Absolute Event Rate: 50% vs 54%
Duration of ECMO support alone is not a prognostic factor for hospital survival, though long-term support in patients with malignancy is associated with adverse prognosis.
Long-term ECMO data in ARDS remain limited; this cohort extends observational experience but leaves practice implications open.
The duration of extracorporeal membrane oxygenation (ECMO) treatments increases, however, data presented from prolonged support is limited. We retrospectively analyzed all patients during a 4-year period undergoing respiratory ECMO for duration of therapy, demographics, therapy-associated parameters, and outcome according to ECMO duration (<28 days and ≥28 days = long-term ECMO). Out of 55 patients undergoing ECMO for ARDS or during bridging to lung transplantation, 18 were on ECMO for ≥28 days (33%). In the long-term group, median ECMO run time was 40 days (interquartile range 34-54 days). Hospital survival was not significantly different between the groups (54% in short-term and 50% in long-term ECMO patients). There was a significantly higher proportion of patients suffering from malignancy in the group of long-term nonsurvivors. Recovery occurred after more than 40 days on ECMO in 3 patients. The longest ECMO run time in a hospital survivor was 65 days. Duration of ECMO support alone was no prognostic factor and should not represent a basis for decision-making. In patients suffering from malignancy, long-term ECMO support seems to be a factor of adverse prognosis, if not futile.
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Bojic et al. (2020) conducted a cohort in ARDS or bridging to lung transplantation (n=55). Long-term ECMO (≥28 days) vs. Short-term ECMO (<28 days) was evaluated on Hospital survival. Long-term ECMO support (≥28 days) resulted in similar hospital survival compared to short-term ECMO (<28 days) (50% vs 54%).
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