Does Earlier Cannulation With Veno-Venous Extracorporeal Membrane Oxygenation in Adult Patients With Acute Respiratory Distress Syndrome Decrease Duration of Artificial Mechanical Ventilation? /
Christine Hartner, Jacqueline Ochsenreither, Kenneth Miller, Michael Weiss
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Acute respiratory distress syndrome (ARDS) is defined as acute onset of hypoxemia resistant to oxygen therapy alone (Linden et al., 2000). Primary treatment for ARDS is artificial mechanical ventilation (AMV) (Wu, Huang, Wu, Wang, & Lin, 2016). Given recent advances in technology, the use of VenoVenous Extracorporeal Membrane Oxygenation (VV-ECMO) to treat severe ARDS is growing rapidly (Combes et al., 2014). Unfortunately, criteria for the initiation of VV-ECMO in adult patients with ARDS differs among healthcare organizations. This 49-month quantitative, retrospective inpatient EMR chart review compared if cannulation with VV-ECMO up to and including 48 hours of admission and diagnosis in adult patients 30-65 years of age diagnosed with ARDS, decreased duration on artificial mechanical ventilation, as compared to participants who were cannulated after 48 hours of admission and diagnosis with ARDS. A total of 110 participants were identified as receiving VV-ECMO during the study timeframe. A total of 52 participants were excluded due to age and dia gnosis. Of the 58 participants who met all inclusion criteria, 39 participants were cannulated for VV-ECMO within 48 hours of admission and diagnosis with ARDS, and 19 participants were cannulated with VV-ECMO after 48 hours of admission and diagnosis with ARDS. Data collected demonstrated no statistically significant (p < 0.579) difference in length of days on AMV between participant groups. Further studies are needed to determine if earlier initiation of VV-ECMO in adult patients with ARDS decrease time on AMV.