As a life-saving therapy for patients with acute respiratory failure (ARF)Mechanical ventilation has catalyzed the development of modern emergency medicine and intensive care units.Another way to support respiratory or cardiac functions is extracorporeal membrane oxygenation (ECMO).Based on previous studies, the increased pre-ECMO time of mechanical ventilation is a significant independent predictor of the poorer outcome. Removal or maintaining of mechanical ventilation during ECMO is still debatable.
We analyzed the clinical data of 23 patients veno-venous ECMO therapy with acute respiratory failure due to adult community-acquired pneumonia.They were divided into two groups: group A (removed of mechanical ventilation, n = 10) and group B ( maintaining of mechanical ventilation,n = 13).Demographic data, including gender, age, smoking habits were collected. General characteristics and Clinical characteristics of patients were also recorded, in order to discuss whether the retention or removal of trachea cannula and continued mechanical ventilation during ECMO can affect patients’ prognosis.
After analysis, patients in the Group B were older than the Group A (61.0 y [54.5–67.5] vs 39.0 y [24.0-61.8], P = 0.021). The median APACHE Ⅱ score of 23 patients before ECMO therapy was 25.0 (IQR, 21.0–28.0), and the Group A had a lower initial APACHE Ⅱ score than the Group B (21.5 [20.8–24.3] vs 28.0 [24.0–29.0], P = 0.005).The group A with a survival rate of 80%, and the group B presenting a survival rate of 23.1%.The difference in the survival rate between the two groups was statistically significant (P = 0.012).No differences in other items were found between the two groups.
The final results showed that the removing of mechanical ventilation during ECMO can improve the survival rate and prognosis in patients with ARF.