title: Outcomes using extracorporeal life support for adult respiratory failure due to status asthmaticus.
abstract: Our objective was to describe the outcomes for extracorporeal life support (ECLS) use in adult respiratory failure because of status asthmaticus and to determine whether ECLS use in status asthmaticus is associated with greater survival than other indications for ECLS. This retrospective cohort study used the multicenter, International ECLS Organization Registry. The study population included 1,257 adults with respiratory failure requiring ECLS. Status asthmaticus was the primary indication for ECLS in 24 patients. A total of 83.3% of asthmatics survived to hospital discharge compared with 50.8% of nonasthmatics (n=1,233) [odds ratio (OR) favoring survival for asthmatics=4.86, 95% confidence interval (CI) 1.65-14.31, p=0.004]. The survival advantage for asthmatics remained significant after adjustment for potential confounders. Complications were noted in 19 of 24 asthmatics (79.2%). In conclusion, we found that status asthmaticus, as an indication for ECLS in adult respiratory failure, seemed to be associated with greater survival than other indications for ECLS. However, complications are common and whether ECLS confers a survival advantage compared with other salvage treatment options remains unknown. More detailed information and complete reporting of ECLS use for status asthmaticus are needed to determine whether and when the potentially life-saving intervention of ECLS should be initiated in the asthmatic failing conventional therapy.
authors.affiliation: Pulmonary, Allergy, and Critical Care Division, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. mark.mikkelsen@uphs.upenn.edu
authors.forename: Mark E
authors.initials: ME
authors.lastname: Mikkelsen
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Sager
authors.forename: Barry D
authors.initials: BD
authors.lastname: Fuchs
authors.forename: Jason D
authors.initials: JD
authors.lastname: Christie
mesh_terms: D000328:Adult; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D008020:Life Support Care / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D012042:Registries; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D013224:Status Asthmaticus / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome