单位：[1]National Clinical Research Center for Respiratory Diseases, Center forRespiratory Diseases, China-Japan Friendship Hospital, Beijing, China[2]Department of Pulmonary and Critical Care Medicine, China-JapanFriendship Hospital, Beijing, China[3]Capital Medical University, Beijing, China[4]Institute of Clinical Medical Sciences, China-Japan Friendship Hospital,Beijing, China
Background: The use of extracorporeal membrane oxygenation (ECMO) in awake, spontaneously breathing and non-intubated patients (awake ECMO) may be a novel therapeutic strategy for severe acute respiratory distress syndrome (ARDS) patients. The purpose of this study is to assess the feasibility and safety of awake ECMO in severe ARDS patients receiving prolonged ECMO (> 14 days). Methods: We describe our experience with 12 consecutive severe ARDS patients (age, 39.1 +/- 16.4 years) supported with awake ECMO to wait for native lung recovery during prolonged ECMO treatment from July 2013 to January 2018. Outcomes are reported including the hospital mortality, ECMO-related complications and physiological data on weaning from invasive ventilation. Results: The patients received median 26.0 (15.5, 64.8) days of total ECMO duration in the cohort. The longest ECMO support duration was 121 days. Awake ECMO and extubation was implemented after median 10.2(5.0, 42.9) days of ECMO. Awake ECMO was not associated with increased morbidity. The total invasive ventilation duration, lengths of stay in the ICU and hospital in the cohort were 14.0(12.0, 37.3) days, 33.0(22.3, 56.5) days and 46.5(27.3, 84.8) days, respectively. The hospital mortality rate was 33.3% (4/12) in the cohort. Survivors had more stable respiratory rate and heart rate after extubation when compared to the non-survivors. Conclusions: With carefully selected patients, awake ECMO is a feasible and safe strategy for severe pulmonary ARDS patients receiving prolonged ECMO support to wait for native lung recovery.
基金：
National Key Research and Development Program of China [2016YFC1304300]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81700083]; CAMS Innovation Fund for Medical Sciences [2018-I2M-1-003]; Non-profit Central Research Institute Fund of CAMS [2019TX320006]
第一作者单位：[1]National Clinical Research Center for Respiratory Diseases, Center forRespiratory Diseases, China-Japan Friendship Hospital, Beijing, China[2]Department of Pulmonary and Critical Care Medicine, China-JapanFriendship Hospital, Beijing, China
通讯作者：
通讯机构：[1]National Clinical Research Center for Respiratory Diseases, Center forRespiratory Diseases, China-Japan Friendship Hospital, Beijing, China[2]Department of Pulmonary and Critical Care Medicine, China-JapanFriendship Hospital, Beijing, China
推荐引用方式(GB/T 7714)：
Jingen Xia,Sichao Gu,Min Li,et al.Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation[J].BMC PULMONARY MEDICINE.2019,19(1):doi:10.1186/s12890-019-1016-2.
APA：
Jingen Xia,Sichao Gu,Min Li,Donglin Liu,Xu Huang...&Qingyuan Zhan.(2019).Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation.BMC PULMONARY MEDICINE,19,(1)
MLA：
Jingen Xia,et al."Spontaneous breathing in patients with severe acute respiratory distress syndrome receiving prolonged extracorporeal membrane oxygenation".BMC PULMONARY MEDICINE 19..1(2019)
