title: Extracorporeal membrane oxygenation in adult patients with severe acute respiratory failure.
abstract: BACKGROUND
  A group of patients with severe acute respiratory distress syndrome (ARDS) is resistant to advanced respiratory therapy. In these patients, extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy. This study presents 14 years of experience from a Scandinavian ECMO centre. The aim of the study is to present outcome results and to investigate whether or not simplified acute physiology score II (SAPS-II), sequential organ failure assessment (SOFA) and/or Murray scores can be used to predict patients' outcome.
  
  
  METHODS
  In a prospective observational study, we collected data from ECMO patients from January 1997 to March 2011. The treatment was based mainly on venous-venous ECMO and centrifugal pumps. Patients were retrieved from Denmark plus a number from Sweden and Norway. The inclusion criteria were the classical criteria until November 2009 (n = 100), after which the new Extracorporeal Life Support Organisation criteria (n = 24) were used.
  
  
  RESULTS
  One hundred and twenty-four patients were enrolled with median age 45 (range 16-67) years. The median Murray score was 3.7 (2.5-4.0). One hundred and six (85%) of the patients were retrieved from referring hospitals on ECMO. The median duration of the ECMO runs was 215 (1-578) h. Ninety-seven (78%) of the patients could be weaned from ECMO. A total of 88 (71%) were discharged alive to the referring hospitals. High SAPS-II, SOFA and Murray scores were associated with a high mortality.
  
  
  CONCLUSIONS
  Patients with severe ARDS have a favourable outcome when treated with ECMO and when an ECMO retrieval team establishes the ECMO treatment at the referring hospital. SAPS-II, SOFA and Murray scores predicted the outcome.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Aarhus University Hospital, Skejby, Aarhus N, Denmark. chrilind@rm.dk
authors.forename: C
authors.initials: C
authors.lastname: Lindskov
authors.forename: R H
authors.initials: RH
authors.lastname: Jensen
authors.forename: P
authors.initials: P
authors.lastname: Sprogoe
authors.forename: K E
authors.initials: KE
authors.lastname: Klaaborg
authors.forename: H
authors.initials: H
authors.lastname: Kirkegaard
authors.forename: I K
authors.initials: IK
authors.lastname: Severinsen
authors.forename: A G
authors.initials: AG
authors.lastname: Lorentsen
authors.forename: L
authors.initials: L
authors.lastname: Folkersen
authors.forename: S
authors.initials: S
authors.lastname: Ilkjaer
authors.forename: C M
authors.initials: CM
authors.lastname: Pedersen
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D003422:Critical Care; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015300:Ventilator Weaning; D055815:Young Adult