대한신장학회

논문분류	춘계학술대회 초록집
제목	Clinical Course of Patients Receiving Extra Corporeal Membrane Oxygenation (ECMO): 10 Year-experience of a Single Tertiary Center
저자	Sung Woo Lee2, Jae Yoon Park1, Ha Jeong Lee1, Shin Young Ahn2, Sejoong Kim2, Ho Jun Chin2, Kwon Wook Joo1, Dong-Wan Chae2, Ki Young Na2
출판정보	2015; 2015(1):
키워드	체외막산호화장치,사망률,급성신손상
초록	Background: There has been a paucity of literatures on the clinical course of patients receiving Extra Corporeal Membrane Oxygenation (ECMO) in Korea. Methods: Medical records were reviewed from July 2003 to September 2014 in Seoul national university Bundang hospital. Among 295 patients who had code for ECMO, 171 were included for the analysis: the excluded were age<20 years (n=8), death within 24hours (n=30), non-ECMO receiver (n=14), on renal replacement therapy (RRT, n=6) and on the course of continuous RRT (n=66). Clinical parameter, chronic diseases and laboratory results at the time of ECMO insertion were collected. The stage of Acute kidney injury (AKI) was defined following KDIGO guideline. Results: Mean age was 62.7±14.3 years and 108 (63.2%) were male. 102 (59.6%) and 42 (24.6%) received ECMO because of cardiac and pulmonary problem, respectively. The mean simplified acute physiology score 2 (SAPS2) was 57.9±13.0. The proportion of venoarterial and venovenous ECMO were 75.4% (129/171) and 24.6% (42/171), respectively. The in-hospital mortality was 57.3% (98/171) with median (interquartile range) survival of 17 days (7-41). The cumulative incidences of acute kidney injury (AKI) stage 1-3 were 70.2% (120/171), 50.9% (87/171) and 43.9% (75/171), respectively. The mean renal survival were 3.7±7.7 days, 5.5±10.0 days and 5.3±9.9 days in AKI stage 1-3, respectively. We performed multivariate cox proportional hazard model to identify risk factors. SAPS2 was the only risk factor for the in-hospital mortality. Although no associated factor for AKI stage 1 was identified, hyperbilirubinemia, SAPS2, neutrophil count and ECMO mode were significant risk factors for AKI stage 2-3. Conclusion: Patients receiving ECMO showed high incidence of in-hospital mortality and AKI. SAPS2 was independent risk factor for the in-hospital mortality and AKI stage 2-3. Hyperbilirubinemia, neutrophil count and ECMO mode were associated with the future AKI stage 2-3. Prospective study needs to be followed to confirm our results.
원문(PDF)	PDF 원문보기

간행물 검색

대한신장학회 회원관리 규정