Curative effect of extracorporeal membrane oxygenation on severe acute respiratory distress syndrome and its prognosis of patients

Abstract:

Objective：To explore the curative effect of extracorporeal membrane oxygenation（ECMO） on severe acute respiratory dis－tress syndrome（ARDS） and its influences on prognosis of patients. Methods：Sixty patients with severe ARDS who were admitted to the hospital from September 2015 to September 2019 were enrolled as study objects，and they were randomized into control group（n=30）and observation group（n=30）. The control group was treated with ventilator，while the observation group was treated with ECMO. The hemodynamic indexes [heart rate（HR），pulmonary arterial pressure（PAP），cardiac output index（CI）]，blood gas indexes[partial pressure of oxygen（PaO2），partial pressure of carbon dioxide（PaCO2），blood oxygen saturation（SaO2），mixed venous oxygen partial pressure（PvO2），mixed venous carbon dioxide partial pressure（PvCO2），mixed venous oxygen saturation（SvO2）]，oxygen metabolism indexes[oxygen consumption（VO2），oxygen delivery（DO2），oxygen extraction rate（ERO2），blood lactic acid（Lac）]，incidence of com－plications，success rate of weaning and survival were compared between the two groups. Results：After treatment，HR，PAP and CI in observation group were higher than those in control group（P<0.05）. After treatment，PaO2，SaO2，PvO2 and SvO2 in observation group were higher than those in control group，while PaCO2 and PvCO2 were lower than those in control group（P<0.05）. After treatment，DO2，VO2 and ERO2 were higher in observation group than control group，while Lac was lower than control group（P<0.05）. The incidence of complications in observation group was lower than that in control group（6.67% vs. 26.67%）（P<0.05）. The success rate of wean－ing and 3-month survival rate in observation group were higher than those in control group，without significant difference（P>0.05）. Conclusion：ECMO has a significant curative effect on severe ARDS patients，which can improve oxygen metabolism，and maintain hemodynamics stability，reduce incidence of complications and mortality，and can be applied as an effective means for clinical treat－ment of severe ARDS.