Kochanek, Matthias ORCID: 0000-0002-4766-4651, Kochanek, Jan, Boell, Boris, Eichenauer, Dennis A., Beutel, Gernot, Bracht, Hendrik, Braune, Stephan, Eisner, Florian, Friesecke, Sigrun, Guenther, Ulf, Heinz, Gottfried, Hallek, Michael ORCID: 0000-0002-7425-4455, Karagiannidis, Christian, Kluge, Stefan, Kogelmann, Klaus, Lebiedz, Pia, Lepper, Philipp M., Liebregts, Tobias, Lueck, Catherina, Muellenbach, Ralf M., Hansen, Matthias, Putensen, Christian, Schellongowski, Peter, Schewe, Jens-Christian, Schumann-Stoiber, Kathrin, Seiler, Frederik, Spieth, Peter ORCID: 0000-0003-3953-3253, Weber-Carstens, Steffen, Brodie, Daniel, Azoulay, Elie and Shimabukuro-Vornhagen, Alexander (2022). Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis. Intensive Care Med., 48 (3). S. 332 - 343. NEW YORK: SPRINGER. ISSN 1432-1238

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Abstract

Purpose The question of whether cancer patients with severe respiratory failure benefit from veno-venous extracorporeal membrane oxygenation (vv-ECMO) remains unanswered. We, therefore, analyzed clinical characteristics and outcomes of a large cohort of cancer patients treated with vv-ECMO with the aim to identify prognostic factors. Methods 297 cancer patients from 19 German and Austrian hospitals who underwent vv-ECMO between 2009 and 2019 were retrospectively analyzed. A multivariable cox proportional hazards analysis for overall survival was performed. In addition, a propensity score-matched analysis and a latent class analysis were conducted. Results Patients had a median age of 56 (IQR 44-65) years and 214 (72%) were males. 159 (54%) had a solid tumor and 138 (47%) a hematologic malignancy. The 60-day overall survival rate was 26.8% (95% CI 22.1-32.4%). Low platelet count (HR 0.997, 95% CI 0.996-0.999; p = 0.0001 per 1000 platelets/mu l), elevated lactate levels (HR 1.048, 95% CI 1.012-1.084; p = 0.0077), and disease status (progressive disease [HR 1.871, 95% CI 1.081-3.238; p = 0.0253], newly diagnosed [HR 1.571, 95% CI 1.044-2.364; p = 0.0304]) were independent adverse prognostic factors for overall survival. A propensity score-matched analysis with patients who did not receive ECMO treatment showed no significant survival advantage for treatment with ECMO. Conclusion The overall survival of cancer patients who require vv-ECMO is poor. This study shows that the value of vv-ECMO in cancer patients with respiratory failure is still unclear and further research is needed. The risk factors identified in the present analysis may help to better select patients who may benefit from vv-ECMO.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Kochanek, MatthiasUNSPECIFIEDorcid.org/0000-0002-4766-4651UNSPECIFIED
Kochanek, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boell, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eichenauer, Dennis A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beutel, GernotUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bracht, HendrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braune, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eisner, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Friesecke, SigrunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guenther, UlfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinz, GottfriedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDorcid.org/0000-0002-7425-4455UNSPECIFIED
Karagiannidis, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kluge, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kogelmann, KlausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lebiedz, PiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lepper, Philipp M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebregts, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lueck, CatherinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Muellenbach, Ralf M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hansen, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Putensen, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schellongowski, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schewe, Jens-ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schumann-Stoiber, KathrinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seiler, FrederikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spieth, PeterUNSPECIFIEDorcid.org/0000-0003-3953-3253UNSPECIFIED
Weber-Carstens, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brodie, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azoulay, ElieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shimabukuro-Vornhagen, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-697241
DOI: 10.1007/s00134-022-06635-y
Journal or Publication Title: Intensive Care Med.
Volume: 48
Number: 3
Page Range: S. 332 - 343
Date: 2022
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-1238
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DISTRESS-SYNDROME; LIFE-SUPPORT; IMMUNOCOMPROMISED PATIENTS; EPIDEMIOLOGY; MANAGEMENT; OUTCOMES; INJURY; CAREMultiple languages
Critical Care MedicineMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69724

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