Please use this identifier to cite or link to this item: https://doi.org/10.1097/CCM.0000000000002320
Title: Extracorporeal membrane oxygenation for adult community-Acquired pneumonia: Outcomes and predictors of mortality
Authors: Ramanathan K. 
Tan C.S.
Rycus P.
Maclaren G. 
Keywords: Complications
Extracorporeal
Pneumonia
Risk factors
Issue Date: 1-May-2017
Publisher: Lippincott Williams and Wilkins
Citation: Ramanathan K., Tan C.S., Rycus P., Maclaren G. (2017-05-01). Extracorporeal membrane oxygenation for adult community-Acquired pneumonia: Outcomes and predictors of mortality. Critical Care Medicine 45 (5) : 814-821. ScholarBank@NUS Repository. https://doi.org/10.1097/CCM.0000000000002320
Abstract: Objectives: Extracorporeal membrane oxygenation is a rescue therapy used to support severe cardiorespiratory failure. Data on outcomes from severe community-Acquired pneumonia in adults receiving rescue extracorporeal membrane oxygenation are mainly confined to single-center experiences or specific pathogens. We examined data from the Extracorporeal Life Support Organisation registry to identify risk factors for poor outcomes in adult patients with community-Acquired pneumonia. Design: Retrospective data analysis. Setting: Extracorporeal Life Support Organization Registry database. Patients: We collected deidentified data on adult patients (> 18 yr) receiving extracorporeal membrane oxygenation for community-Acquired pneumonia between 2002 and 2012. Patients with incomplete data or brain death were excluded. The primary outcome measure was in-hospital mortality. Other measurements included demographic information, pre-extracorporeal membrane oxygenation mechanical ventilation and biochemical variables, inotrope requirements, extracorporeal membrane oxygenation mode, duration, and complications. Initial univariate analysis assessed potential associations between survival and various pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation factors. Variables with p values of less than 0.1 were considered for logistic regression analysis to identify predictors of mortality. Interventions: None. Measurements and Main Findings: One thousand fifty-five patients, who satisfied inclusion criteria, were included in the final analysis. There was an increase in the number of patients cannulated per annum over the 10-year period studied. Univariate analysis identified pre-extracorporeal membrane oxygenation and extracorporeal membrane oxygenation variables associated with high mortality. Further multiple regression analysis identified certain pre-extracorporeal membrane oxygenation factors as predictors of mortality, including duration of mechanical ventilation prior to extracorporeal membrane oxygenation, lower arterial pressure, fungal pneumonia, and advancing age. Type and duration of extracorporeal membrane oxygenation, neurologic complications, and presence of more than three complications on extracorporeal membrane oxygenation were also associated with higher mortality. Conclusions: The majority (66%) of adults with communityacquired pneumonia supported on extracorporeal membrane oxygenation survived. Certain potentially modifiable risk factors were associated with increased mortality. � 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
Source Title: Critical Care Medicine
URI: http://scholarbank.nus.edu.sg/handle/10635/146734
ISSN: 00903493
DOI: 10.1097/CCM.0000000000002320
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

1
checked on Sep 17, 2018

Page view(s)

3
checked on Sep 20, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.