Universität zu Köln

Wohlfarth, Philipp ORCID: 0000-0001-5628-7942, Beutel, Gernot, Lebiedz, Pia, Stemmler, Hans-Joachim, Staudinger, Thomas, Schmidt, Matthieu, Kochanek, Matthias, Liebregts, Tobias, Taccone, Fabio Silvio, Azoulay, Elie, Demoule, Alexandre, Kluge, Stefan, Svalebjorg, Morten, Lueck, Catherina, Tischer, Johanna, Combes, Alain, Boell, Boris, Rabitsch, Werner and Schellongowski, Peter (2017). Characteristics and Outcome of Patients After Allogeneic Hematopoietic Stem Cell Transplantation Treated With Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome. Crit. Care Med., 45 (5). S. E500 - 8. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1530-0293

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Abstract

Objectives: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. Design: Multicenter, retrospective, observational study. Setting: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium). Patients: All allogeneic hematopoietic stem cell transplantation recipients treated with venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome between 2010 and 2015. Interventions: None. Measurements and Main Results: Thirty-seven patients, nine of whom underwent noninvasive ventilation at the time of extracorporeal membrane oxygenation initiation, were analyzed. ICU admission occurred at a median of 146 (interquartile range, 27-321) days after allogeneic hematopoietic stem cell transplantation. The main reason for acute respiratory distress syndrome was pneumonia in 81% of patients. All but one patient undergoing noninvasive ventilation at extracorporeal membrane oxygenation initiation had to be intubated thereafter. Overall, seven patients (19%) survived to hospital discharge and were alive and in remission of their hematologic disease after a follow-up of 18 (range, 5-30) months. Only one of 24 patients (4%) initiated on extracorporeal membrane oxygenation within 240 days after allogeneic hematopoietic stem cell transplantation survived compared to six of 13 (46%) of those treated thereafter (p < 0.01). Fourteen patients (38%) experienced bleeding events, of which six (16%) were associated with fatal outcomes. Conclusions: Discouraging survival rates in patients treated early after allogeneic hematopoietic stem cell transplantation do not support the use of extracorporeal membrane oxygenation for acute respiratory distress syndrome in this group. On the contrary, longterm allogeneic hematopoietic stem cell transplantation recipients otherwise eligible for full-code ICU management may be potential candidates for extracorporeal membrane oxygenation therapy in case of severe acute respiratory distress syndrome failing conventional measures.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wohlfarth, Philipp UNSPECIFIED orcid.org/0000-0001-5628-7942 UNSPECIFIED Beutel, Gernot UNSPECIFIED UNSPECIFIED UNSPECIFIED Lebiedz, Pia UNSPECIFIED UNSPECIFIED UNSPECIFIED Stemmler, Hans-Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Staudinger, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthieu UNSPECIFIED UNSPECIFIED UNSPECIFIED Kochanek, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebregts, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Taccone, Fabio Silvio UNSPECIFIED UNSPECIFIED UNSPECIFIED Azoulay, Elie UNSPECIFIED UNSPECIFIED UNSPECIFIED Demoule, Alexandre UNSPECIFIED UNSPECIFIED UNSPECIFIED Kluge, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Svalebjorg, Morten UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueck, Catherina UNSPECIFIED UNSPECIFIED UNSPECIFIED Tischer, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Combes, Alain UNSPECIFIED UNSPECIFIED UNSPECIFIED Boell, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED Rabitsch, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Schellongowski, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-233139
DOI:	10.1097/CCM.0000000000002293
Journal or Publication Title:	Crit. Care Med.
Volume:	45
Number:	5
Page Range:	S. E500 - 8
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1530-0293
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSIVE-CARE; PULMONARY COMPLICATIONS; FAILURE; MORTALITY; SUPPORT; SCORE; RECIPIENTS; SURVIVAL Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23313