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Near-fatal asthma treated effectively by ECMO


 

FROM CHEST 2017

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Extracorporeal membrane oxygenation (ECMO) is an effective way to treat near fatal asthma, but physicians must remember the risk of complications, according to an abstract on a study scheduled to be presented at CHEST 2017.

The study covers a retrospective analysis of 371 children with asthma who were treated with ECMO; it used data collected by the Extracorporeal Life Support Organization registry from 1988 to 2016. The median age of the children in the study was 7.5 years; the participant group was 43% white and 39% black, as well as 56% male, according to the abstract, which is mentioned in the program for the CHEST annual meeting.

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Median ECMO time was 123 hours, with 65% of procedures being venovenous (VV) cannulation and 33% of procedures being venoarterial (VA) cannulation. Nearly 90% of patients had hypercarbic respiratory failure, 34% had hypoxic respiratory failure, and 27% had combined respiratory failure. Children with hypercarbic respiratory failure were more likely to receive VV cannulation (P = .003), while children with hypoxic or combined respiratory failure were more likely to receive VA cannulation, (P = .0008 and .01, respectively).

About 80% of children experienced at least one complication, with 20% experiencing three or more. Children who had three or more complications were significantly less likely to experience lung recovery.

Of the children who received VV cannulation, 90% experienced lung recovery, whereas only 69% of children who received VA cannulation recovered. (P less than .0001). VA cannulation was also associated with a higher risk of neurological complications, while those who received VV cannulation were significantly more likely to survive.

The abstract is scheduled to be presented on Sunday Oct. 29 from 2:30 p.m. to 2:45 p.m. in Room 603 of Toronto Convention Centre South Building as part of the Acute Lung Injury & Respiratory Failure session, which will run from 1:30 p.m. to 3 p.m.

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