Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis
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Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis. / Kochanek, Matthias; Kochanek, Jan; Böll, Boris; Eichenauer, Dennis A; Beutel, Gernot; Bracht, Hendrik; Braune, Stephan; Eisner, Florian; Friesecke, Sigrun; Günther, Ulf; Heinz, Gottfried; Hallek, Michael; Karagiannidis, Christian; Kluge, Stefan; Kogelmann, Klaus; Lebiedz, Pia; Lepper, Philipp M; Liebregts, Tobias; Lueck, Catherina; Muellenbach, Ralf M; Hansen, Matthias; Putensen, Christian; Schellongowski, Peter; Schewe, Jens-Christian; Schumann-Stoiber, Kathrin; Seiler, Frederik; Spieth, Peter; Weber-Carstens, Steffen; Brodie, Daniel; Azoulay, Elie; Shimabukuro-Vornhagen, Alexander.
in: INTENS CARE MED, Jahrgang 48, Nr. 3, 03.2022, S. 332-342.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Veno-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure in adult cancer patients: a retrospective multicenter analysis
AU - Kochanek, Matthias
AU - Kochanek, Jan
AU - Böll, Boris
AU - Eichenauer, Dennis A
AU - Beutel, Gernot
AU - Bracht, Hendrik
AU - Braune, Stephan
AU - Eisner, Florian
AU - Friesecke, Sigrun
AU - Günther, Ulf
AU - Heinz, Gottfried
AU - Hallek, Michael
AU - Karagiannidis, Christian
AU - Kluge, Stefan
AU - Kogelmann, Klaus
AU - Lebiedz, Pia
AU - Lepper, Philipp M
AU - Liebregts, Tobias
AU - Lueck, Catherina
AU - Muellenbach, Ralf M
AU - Hansen, Matthias
AU - Putensen, Christian
AU - Schellongowski, Peter
AU - Schewe, Jens-Christian
AU - Schumann-Stoiber, Kathrin
AU - Seiler, Frederik
AU - Spieth, Peter
AU - Weber-Carstens, Steffen
AU - Brodie, Daniel
AU - Azoulay, Elie
AU - Shimabukuro-Vornhagen, Alexander
N1 - © 2022. The Author(s).
PY - 2022/3
Y1 - 2022/3
N2 - PURPOSE: The question of whether cancer patients with severe respiratory failure benefit from veno-venous extracorporeal membrane oxygenation (vv-ECMO) remains unanswered. We, therefore, analyzed clinical characteristics and outcomes of a large cohort of cancer patients treated with vv-ECMO with the aim to identify prognostic factors.METHODS: 297 cancer patients from 19 German and Austrian hospitals who underwent vv-ECMO between 2009 and 2019 were retrospectively analyzed. A multivariable cox proportional hazards analysis for overall survival was performed. In addition, a propensity score-matched analysis and a latent class analysis were conducted.RESULTS: Patients had a median age of 56 (IQR 44-65) years and 214 (72%) were males. 159 (54%) had a solid tumor and 138 (47%) a hematologic malignancy. The 60-day overall survival rate was 26.8% (95% CI 22.1-32.4%). Low platelet count (HR 0.997, 95% CI 0.996-0.999; p = 0.0001 per 1000 platelets/µl), elevated lactate levels (HR 1.048, 95% CI 1.012-1.084; p = 0.0077), and disease status (progressive disease [HR 1.871, 95% CI 1.081-3.238; p = 0.0253], newly diagnosed [HR 1.571, 95% CI 1.044-2.364; p = 0.0304]) were independent adverse prognostic factors for overall survival. A propensity score-matched analysis with patients who did not receive ECMO treatment showed no significant survival advantage for treatment with ECMO.CONCLUSION: The overall survival of cancer patients who require vv-ECMO is poor. This study shows that the value of vv-ECMO in cancer patients with respiratory failure is still unclear and further research is needed. The risk factors identified in the present analysis may help to better select patients who may benefit from vv-ECMO.
AB - PURPOSE: The question of whether cancer patients with severe respiratory failure benefit from veno-venous extracorporeal membrane oxygenation (vv-ECMO) remains unanswered. We, therefore, analyzed clinical characteristics and outcomes of a large cohort of cancer patients treated with vv-ECMO with the aim to identify prognostic factors.METHODS: 297 cancer patients from 19 German and Austrian hospitals who underwent vv-ECMO between 2009 and 2019 were retrospectively analyzed. A multivariable cox proportional hazards analysis for overall survival was performed. In addition, a propensity score-matched analysis and a latent class analysis were conducted.RESULTS: Patients had a median age of 56 (IQR 44-65) years and 214 (72%) were males. 159 (54%) had a solid tumor and 138 (47%) a hematologic malignancy. The 60-day overall survival rate was 26.8% (95% CI 22.1-32.4%). Low platelet count (HR 0.997, 95% CI 0.996-0.999; p = 0.0001 per 1000 platelets/µl), elevated lactate levels (HR 1.048, 95% CI 1.012-1.084; p = 0.0077), and disease status (progressive disease [HR 1.871, 95% CI 1.081-3.238; p = 0.0253], newly diagnosed [HR 1.571, 95% CI 1.044-2.364; p = 0.0304]) were independent adverse prognostic factors for overall survival. A propensity score-matched analysis with patients who did not receive ECMO treatment showed no significant survival advantage for treatment with ECMO.CONCLUSION: The overall survival of cancer patients who require vv-ECMO is poor. This study shows that the value of vv-ECMO in cancer patients with respiratory failure is still unclear and further research is needed. The risk factors identified in the present analysis may help to better select patients who may benefit from vv-ECMO.
U2 - 10.1007/s00134-022-06635-y
DO - 10.1007/s00134-022-06635-y
M3 - SCORING: Journal article
C2 - 35146534
VL - 48
SP - 332
EP - 342
JO - INTENS CARE MED
JF - INTENS CARE MED
SN - 0342-4642
IS - 3
ER -
