title: Long-Term Venovenous Extracorporeal Membrane Oxygenation Support for Acute Respiratory Distress Syndrome.
abstract: BACKGROUND
  Given substantial advances in venovenous extracorporeal membrane oxygenation (ECMO) technology, long-term support is increasingly feasible. Although the benefits of short-term ECMO as a bridge to recovery in acute respiratory distress syndrome (ARDS) are well described, the utility and outcomes of long-term support remain unclear.
  
  
  METHODS
  Patients requiring ECMO for ARDS between January 2009 and November 2012 were retrospectively reviewed and analyzed separately for those requiring ECMO support for less than 3 weeks or for 3 weeks or longer. Demographic factors, ECMO variables, and outcomes were assessed.
  
  
  RESULTS
  Fifty-five patients with ARDS received ECMO during the study period, with 11 patients requiring long-term ECMO support and a median duration of 36 (interquartile range: 24 to 68) days. Recovery was the initial goal in all patients. Pre-ECMO mechanical ventilatory support, indices of disease severity, and the ECMO cannulation strategy were similar between the two groups. Eight (73%) patients receiving long-term support were bridged to recovery, and 1 patient was bridged to transplantation after a refractory course. Eight (73%) patients receiving long-term support and 25 (57%) patients receiving short-term support survived to 30 days and hospital discharge.
  
  
  CONCLUSIONS
  Previously, long-term ECMO support was thought to be associated with unfavorable outcomes. This study, however, may provide support for the efficacy of ECMO support even for 3 weeks or more as a bridge to recovery or transplantation.
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: zkon@smail.umaryland.edu.
authors: Zachary N
authors: ZN
authors: Kon
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Siamak
authors: S
authors: Dahi
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Charles F
authors: CF
authors: Evans
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Kimberly A
authors: KA
authors: Byrnes
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Gregory J
authors: GJ
authors: Bittle
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Brody
authors: B
authors: Wehman
authors: Perfusion Services, University of Maryland Medical Center, Baltimore, Maryland.
authors: Raymond P
authors: RP
authors: Rector
authors: Perfusion Services, University of Maryland Medical Center, Baltimore, Maryland.
authors: Brian M
authors: BM
authors: McCormick
authors: Department of Medicine and Program in Trauma, R Adams Cowley Shock Trauma Center, and University of Maryland School of Medicine, Baltimore, Maryland.
authors: Daniel L
authors: DL
authors: Herr
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Pablo G
authors: PG
authors: Sanchez
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Si M
authors: SM
authors: Pham
authors: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors: Bartley P
authors: BP
authors: Griffith
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult