Background:Acute respiratory distress syndrome(ARDS)has a reported incidence of 34–43%in ventilated burn patients and is associated with a mortality of 59%in the severe form.The use and experience with extracorporeal...Background:Acute respiratory distress syndrome(ARDS)has a reported incidence of 34–43%in ventilated burn patients and is associated with a mortality of 59%in the severe form.The use and experience with extracorporeal membrane oxygenation(ECMO)in burn patients developing ARDS are still limited.We present our results and discuss the significance of ECMO in treating burn patients.Methods:A retrospective analysis of burn patients treated with ECMO for ARDS between January 2017 and January 2019 was performed.Demographic,clinical,and outcome data were collected and analyzed.Results:Eight burn patients were treated at our institution with ECMO in the designated time period.Of these,all but one patient had inhalation injury,burn percentage of TBSA was 37±23%,ABSI score was 8.4±2,and R-Bauxscore was 98±21.Seven patients developed severe ARDS and one patient moderate ARDS according to the Berlin classification with a PaO_(2)/FiO_(2) ratio upon initiation of ECMO therapy of 62±22 mmHg.ECMO duration was 388±283 h.Three patients died from severe sepsis while five patients survived to hospital discharge.Conclusions:ECMO is a viable therapy option in burn patients developing severe ARDS and can contribute to survival rates similar to ECMO therapy in non-burn-associated severe ARDS.Consequently,patients with severe respiratory insufficiency with unsuccessful conventional treatment and suspected worsening should be transferred to burn units with the possibility of ECMO treatment to improve outcome.展开更多
文摘Background:Acute respiratory distress syndrome(ARDS)has a reported incidence of 34–43%in ventilated burn patients and is associated with a mortality of 59%in the severe form.The use and experience with extracorporeal membrane oxygenation(ECMO)in burn patients developing ARDS are still limited.We present our results and discuss the significance of ECMO in treating burn patients.Methods:A retrospective analysis of burn patients treated with ECMO for ARDS between January 2017 and January 2019 was performed.Demographic,clinical,and outcome data were collected and analyzed.Results:Eight burn patients were treated at our institution with ECMO in the designated time period.Of these,all but one patient had inhalation injury,burn percentage of TBSA was 37±23%,ABSI score was 8.4±2,and R-Bauxscore was 98±21.Seven patients developed severe ARDS and one patient moderate ARDS according to the Berlin classification with a PaO_(2)/FiO_(2) ratio upon initiation of ECMO therapy of 62±22 mmHg.ECMO duration was 388±283 h.Three patients died from severe sepsis while five patients survived to hospital discharge.Conclusions:ECMO is a viable therapy option in burn patients developing severe ARDS and can contribute to survival rates similar to ECMO therapy in non-burn-associated severe ARDS.Consequently,patients with severe respiratory insufficiency with unsuccessful conventional treatment and suspected worsening should be transferred to burn units with the possibility of ECMO treatment to improve outcome.
