The influence of ECMO supplemented with lung transplantation on prognosis of patients with end-stage lung diseases and analysis of its related factors
Objective To explore the influence of extracorporeal membrane oxygenation(ECMO)supplemented with lung transplantation on the prognosis of patients with end-stage lung diseases and to analyze its related factors.Methods The data of 87 patients with end-stage lung diseases underwent ECMO-assisted lung transplantation in our hospital from April 2020 to June 2022 were retrospectively analyzed.Among the patients,44 treated with veno-arterial(V-A)bypass were enrolled in a VA-ECMO group,and 43 treated with veno-venous(V-V)bypass were included in a VV-ECMO group.Clinical data,surgery-related indicators and postoperative complications were compared between the two groups.The risk factors affecting the prognosis of the patients were analyzed.Results The average pulmonary artery pressure and the proportion of severe arterial pressure in the VA-ECMO group were significantly higher than those in the VV-ECMO group(P<0.05).The surgical time in the VA-ECMO group was significantly longer than that in the VV-ECMO group(P<0.05).The ECMO flow time in the VA-ECMO group was significantly lower than that in the VV-ECMO group(P<0.05).There were no statistically significant differences in primary graft dysfunction(PGD)rate after surgery,shock rate within 72h after surgery,retracheal intubation or tracheotomy rate,and 6-month postoperative survival rate between the two groups(P>0.05).Multivariate logistic regression analysis showed that pulmonary artery pressure,ECMO bypass time,postoperative PGD and retracheal intubation or tracheotomy were risk factors affecting the prognosis of these patients(P<0.05).Conclusions There is no significant difference in short-term prognosis between patients with VA bypass and with VV bypass in ECMO-assisted lung transplantation for end-stage lung diseases.The risk factors affecting the prognosis of the patients are pulmonary artery pressure,ECMO bypass time,postoperative PGD and retracheal intubation or tracheotomy.
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