title: Systemic inflammatory response syndrome (SIRS) after extracorporeal membrane oxygenation (ECMO): Incidence, risks and survivals.
abstract: Systemic inflammatory response syndrome (SIRS) is frequently observed after extracorporeal membrane oxygenation (ECMO) decannulation; however, these issues have not been investigated well in the past.
  
  
  
  Retrospective chart review was performed to identify post-ECMO SIRS phenomenon, defined by exhibiting 2/3 of the following criteria: fever, leukocytosis, and escalation of vasopressors. The patients were divided into 2 groups: patients with documented infections (Group I) and patients with true SIRS (Group TS) without any evidence of infection. Survival and pre-, intra- and post-ECMO risk factors were analyzed.
  
  
  
  Among 62 ECMO survivors, 37 (60%) patients developed the post-ECMO SIRS phenomenon, including Group I (n = 22) and Group TS (n = 15). The 30-day survival rate of Group I and TS was 77% and 100%, respectively (p = 0.047), although risk factors were identical.
  
  
  
  SIRS phenomenon after ECMO decannulation commonly occurs. Differentiating between the similar clinical presentations of SIRS and infection is important and will impact clinical outcomes.
authors.affiliation: Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Karthik
authors.initials: K
authors.lastname: Thangappan
authors.affiliation: Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Cavarocchi
authors.affiliation: Division of Pulmonary/Critical Care Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Baram
authors.affiliation: Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Brandi
authors.initials: B
authors.lastname: Thoma
authors.affiliation: Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Electronic address: Hitoshi.Hirose@jefferson.edu.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirose
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology* / Q000209:etiology; D016896:Treatment Outcome
keywords: ECMO; Infection; Outcomes; SIRS; Survival