Outcomes of intraoperative venoarterial extracorporeal membrane oxygenation versus cardiopulmonary bypass during lung transplantation

Christian A. Bermudez, Akira Shiose, Stephen A. Esper, Norihisa Shigemura, Jonathan D'Cunha, Jay K. Bhama, Thomas J. Richards, Peter Arlia, Maria M. Crespo, Joseph M. Pilewski

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Results The CPB and ECMO groups had comparable demographic and operative characteristics; however, the ECMO group had higher mean lung allocation scores (73 vs 52, p < 0.001). In the CPB group, more patients required reintubation (35.6% vs 20.4%, p = 0.04) or temporary tracheostomy (44.6% vs 28.6%, p = 0.05). Patients in the CPB group had a higher rate of renal failure requiring dialysis than the ECMO group (22.1% vs 8.2 %, p = 0.028). There were no differences in severe PGD requiring postoperative circulatory support (p = 0.83) or the need for perioperative red blood cell transfusions (p = 0.64) between the groups. No differences in 30-day (5% CPB vs 4.1% ECMO) or 6-month mortality (14.4% CPB vs 14.3% ECMO) were noted.

Conclusions The use of ECMO in lung transplant is safe and in our experience was associated with decreased rates of pulmonary and renal complications, as compared with CPB. Extracorporeal membrane oxygenation has become our preferred method of intraoperative support during lung transplantation.

Background The intraoperative use of cardiopulmonary bypass (CPB) in lung transplantation has been associated with increased rates of pulmonary dysfunction and bleeding complications. More recently, extracorporeal membrane oxygenation (ECMO) has emerged as a valid alternative method of support and has been our preferred method of support since March 2012. We compared early and midterm outcomes of these 2 support methods.

Methods Between July 2007 and April 2013, 271 consecutive patients underwent lung transplant using CPB (n = 222) or ECMO (n = 49). We retrospectively reviewed the outcomes of these patients requiring CPB or ECMO during lung transplant.

元の言語英語
ページ(範囲)1936-1943
ページ数8
ジャーナルAnnals of Thoracic Surgery
98
発行部数6
DOI
出版物ステータス出版済み - 12 1 2014
外部発表Yes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Bermudez, C. A., Shiose, A., Esper, S. A., Shigemura, N., D'Cunha, J., Bhama, J. K., Richards, T. J., Arlia, P., Crespo, M. M., & Pilewski, J. M. (2014). Outcomes of intraoperative venoarterial extracorporeal membrane oxygenation versus cardiopulmonary bypass during lung transplantation. Annals of Thoracic Surgery, 98(6), 1936-1943. https://doi.org/10.1016/j.athoracsur.2014.06.072