Extracorporeal Life Support in Patients with Hematologic Malignancies: A Single Center Experience

Korean J Thorac Cardiovasc Surg. 2016 Aug;49(4):280-6. doi: 10.5090/kjtcs.2016.49.4.280. Epub 2016 Aug 5.

Abstract

Background: Extracorporeal life support (ECLS) in patients with hematologic malignancies is considered to have a poor prognosis. However, to date, there is only one case series reported in the literature. In this study, we compared the in-hospital survival of ECLS in patients with and without hematologic malignancies.

Methods: We reviewed a total of 66 patients who underwent ECLS for treatment of acute respiratory failure from January 2012 to December 2014. Of these patients, 22 (32%) were diagnosed with hematologic malignancies, and 13 (59%) underwent stem cell transplantation before ECLS.

Results: The in-hospital survival rate of patients with hematologic malignancies was 5% (1/22), while that of patients without malignancies was 26% (12/46). The number of platelet transfusions was significantly higher in patients with hematologic malignancies (9.69±7.55 vs. 3.12±3.42 units/day). Multivariate analysis showed that the presence of hematologic malignancies was a significant negative predictor of survival to discharge (odds ratio, 0.07; 95% confidence interval, 0.01-0.79); p=0.031).

Conclusion: ECLS in patients with hematologic malignancies had a lower in-hospital survival rate, compared to patients without hematologic malignancies.

Keywords: Acute respiratory distress syndrome (ARDS); Extracorporeal membrane oxygenation; Hematology.