Analysis of the effect and prognostic factors of VV-ECMO in the treatment of patients with severe ARDS
Objective To investigate the effect and prognostic factors of veno-venous extracorporeal membrane oxygenation(VV-ECMO)in the treatment of patients with severe acute respiratory distress syndrome(ARDS).Methods A retrospective study was conducted to select 100 patients with severe ARDS,including 50 patients treated with VV-ECMO as study group and 50 patients treated with high-frequency oscillatory ventilation as control group.The oxygenation indexes and prognosis of the two groups were compared;the prognostic factors of patients with severe ARDS treated by VV-ECMO were analyze.Results After 24 and 72 h of treatment,the oxygenation index,pH and arterial blood oxygen partial pressure(PaO2)in the study group were higher than those in the control group,and arterial blood carbon dioxide partial pressure(PaCO2),blood lactic acid level and positive end-expiratory pressure(PEEP)were lower than those in the control group(P＜0.05).At 3 months after treatment,there was no significant difference in the survival rate between the two groups(P＞0.05).There were statistically significant differences in age,mechanical ventilation time before ECMO,time from onset to ECMO,ECMO treatment time,heart rate,mean arterial pressure(MAP),blood lactic acid and procalcitonin(PCT)levels among patients with different prognosis in the study group(P＜0.05).Logistic regression analysis results showed that age,mechanical ventilation time before ECMO,time from onset to ECMO,blood lactic acid and PCT were independent risk factors for poor prognosis in patients with severe ARDS treated by VV-ECMO(P＜0.05).Conclusion VV-ECMO treatment can improve the oxygenation index of patients with severe ARDS,and age,mechanical ventilation time before ECMO,time from onset to ECMO,blood lactic acid and PCT are the influencing factors of prognosis.
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