Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience.
BACKGROUND
Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy.


METHODS
The Extracorporeal Life Support Organization Registry was queried for patients aged >or=21 years with diagnoses of malignancy or hematopoietic stem cell transplantation.


RESULTS
Seventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation. Patients required ECLS primarily for pulmonary support (n = 54). The median duration of ECLS was 4.1 days. Overall, 44 patients (61%) died on ECLS, 23 (32%) survived to hospital discharge, and 5 (7%) survived ECLS but died before discharge. Risk factors for death include pulmonary support as reason for ECLS, impaired lung function before ECLS, and development of infection.


CONCLUSIONS
Adults with cancer can be offered ECLS with a small but real expectation for survival. Impaired pulmonary status and the development of infections are associated with death.
Gow
Kenneth W
KW
Department of Surgery, University of Washington, Seattle, WA, USA. kenneth.gow@seattlechildrens.org
Lao
Oliver B
OB
Leong
Traci
T
Fortenberry
James D
JD
D000328:Adult; D000368:Aged; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008020:Life Support Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D011379:Prognosis; D012042:Registries; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome