Outcome of Patients with Interstitial Lung Disease Treated with Extracorporeal Membrane Oxygenation for Acute Respiratory Failure.
BACKGROUND
Patients with interstitial lung disease and acute respiratory failure have a poor prognosis especially if mechanical ventilation is required.


OBJECTIVE
To investigate the outcome of patients with acute respiratory failure in interstitial lung disease undergoing extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or transplantation.


METHODS
This was a retrospective analysis of all patients with interstitial lung disease and acute respiratory failure treated with or without ECMO from March 2012 to August 2015.


RESULTS
Forty patients with interstitial lung disease referred to our intensive care unit for acute respiratory failure were included in the analysis. Twenty-one were treated with ECMO. Eight patients were transferred by air from other hospitals within a range of 320 km (linear distance) for extended intensive care including the option of lung transplant. In total, 13 patients were evaluated, and eight were finally found to be suitable for lung transplantation from an ECMO bridge. Four patients from external hospitals were de novo listed during acute respiratory failure. Six patients underwent lung transplant, and two died on the waiting list after 9 and 63 days on ECMO, respectively. A total of 14 of 15 patients who did not undergo lung transplantation (93.3%) died after 40.3 ± 27.8 days on ECMO. Five out of six patients (83.3%) receiving a lung transplant could be discharged from hospital.


CONCLUSIONS
ECMO is a lifesaving option for patients with interstitial lung disease and acute respiratory failure provided they are candidates for lung transplantation. ECMO is not able to reverse the poor prognosis in patients that do not qualify for lung transplantation.
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Franziska C
FC
Trudzinski
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Franziska
F
Kaestner
2 Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg, Germany; and.
Hans-Joachim
HJ
Schäfers
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Sebastian
S
Fähndrich
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Frederik
F
Seiler
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Philip
P
Böhmer
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Oliver
O
Linn
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Ralf
R
Kaiser
3 Department of Cardiology, Kliniken Maria-Hilf, Mönchengladbach, Germany.
Hendrik
H
Haake
2 Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg, Germany; and.
Frank
F
Langer
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Robert
R
Bals
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Heinrike
H
Wilkens
1 Department of Internal Medicine V-Pneumology and Intensive Care Medicine and.
Philipp M
PM
Lepper
D000208:Acute Disease; D000368:Aged; D016022:Case-Control Studies; D003240:Connective Tissue Diseases / Q000150:complications; D016208:Databases, Factual; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D054988:Idiopathic Interstitial Pneumonias / Q000401:mortality / Q000628:therapy; D017563:Lung Diseases, Interstitial / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
acute respiratory failure; extracorporeal membrane oxygenation; interstitial lung disease; lung transplant