title: Discharge outcome in adults treated with extracorporeal membrane oxygenation.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation (ECMO) is used for critically ill patients when conventional treatments for cardiac or respiratory failure are unsuccessful.
  
  
  OBJECTIVE
  To describe patient and treatment characteristics and discharge outcome for ECMO patients, determine which characteristics are associated with good (survival) versus poor (death before hospital discharge) outcomes, and compare characteristics of patients with cardiac versus respiratory failure indicating ECMO.
  
  
  METHODS
  Single-center, retrospective review of all adult patients treated with ECMO from 2005 through 2009.
  
  
  RESULTS
  A total of 212 patients received ECMO for cardiac (n = 126) or respiratory (n = 86) failure. Mean age was 51 (SD, 14.5) years; support duration was 135 (SD, 149) hours. Survival to discharge was 33% overall; 50% for respiratory indication and 21% for cardiac indication patients. Patients with poor outcomes were older (53 vs 47 years, P = .007), more likely to require cardiovascular support before ECMO (99% vs 91%; P = .02), and had more transfusions (48 vs 24 units, P = .005) and complications (99% vs 87%; P < .001) than did patients with good outcomes. For cardiac patients, older age was associated with poor outcome (poor, 55 vs good, 48 years; P = .01). For respiratory patients, poor outcome was associated with more ventilator days before ECMO (poor, 6 vs good, 3; P = .01), higher peak inspiratory pressure (poor, 39 vs good, 35 cm H2O; P = .02), and lower pulmonary compliance (poor, 19 vs good, 25 mL/cm H2O; P = .008).
  
  
  CONCLUSIONS
  Patients with respiratory indications for ECMO experienced better survival than did cardiac patients. Increasing age was associated with poor outcome. Complications, regardless of ECMO indication, were common and associated with poor outcome.
authors.affiliation: Jane Guttendorf is an acute care nurse practitioner at University of Pittsburgh Medical Center and an assistant professor at University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Arthur J. Boujoukos is an intensivist at University of Pittsburgh Medical Center and a professor in the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. Dianxu Ren is an associate professor and Margaret Q. Rosenzweig is an associate professor at University of Pittsburgh School of Nursing. Marilyn Hravnak is an acute care nurse practitioner at University of Pittsburgh Medical Center and a professor at University of Pittsburgh School of Nursing. jag117@pitt.edu.
authors.forename: Jane
authors.initials: J
authors.lastname: Guttendorf
authors.affiliation: Jane Guttendorf is an acute care nurse practitioner at University of Pittsburgh Medical Center and an assistant professor at University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Arthur J. Boujoukos is an intensivist at University of Pittsburgh Medical Center and a professor in the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. Dianxu Ren is an associate professor and Margaret Q. Rosenzweig is an associate professor at University of Pittsburgh School of Nursing. Marilyn Hravnak is an acute care nurse practitioner at University of Pittsburgh Medical Center and a professor at University of Pittsburgh School of Nursing.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Boujoukos
authors.affiliation: Jane Guttendorf is an acute care nurse practitioner at University of Pittsburgh Medical Center and an assistant professor at University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Arthur J. Boujoukos is an intensivist at University of Pittsburgh Medical Center and a professor in the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. Dianxu Ren is an associate professor and Margaret Q. Rosenzweig is an associate professor at University of Pittsburgh School of Nursing. Marilyn Hravnak is an acute care nurse practitioner at University of Pittsburgh Medical Center and a professor at University of Pittsburgh School of Nursing.
authors.forename: Dianxu
authors.initials: D
authors.lastname: Ren
authors.affiliation: Jane Guttendorf is an acute care nurse practitioner at University of Pittsburgh Medical Center and an assistant professor at University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Arthur J. Boujoukos is an intensivist at University of Pittsburgh Medical Center and a professor in the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. Dianxu Ren is an associate professor and Margaret Q. Rosenzweig is an associate professor at University of Pittsburgh School of Nursing. Marilyn Hravnak is an acute care nurse practitioner at University of Pittsburgh Medical Center and a professor at University of Pittsburgh School of Nursing.
authors.forename: Margaret Q
authors.initials: MQ
authors.lastname: Rosenzweig
authors.affiliation: Jane Guttendorf is an acute care nurse practitioner at University of Pittsburgh Medical Center and an assistant professor at University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Arthur J. Boujoukos is an intensivist at University of Pittsburgh Medical Center and a professor in the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. Dianxu Ren is an associate professor and Margaret Q. Rosenzweig is an associate professor at University of Pittsburgh School of Nursing. Marilyn Hravnak is an acute care nurse practitioner at University of Pittsburgh Medical Center and a professor at University of Pittsburgh School of Nursing.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Hravnak
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion; D002405:Catheterization, Central Venous; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008170:Lung Compliance; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome