The Lung Rescue Unit (LRU) - Does a dedicated intensive care unit for veno-venous extra-corporeal membrane oxygenation (VV ECMO) improve survival to discharge?.

Background: The use of veno-venous extra corporeal membrane oxygenation (VV ECMO) for acute respiratory failure/distress syndrome (ARF/ARDS) has increased since 2009. Specialized units for patients requiring VV ECMO are not standard and patients are often cohorted with other critically ill patients. The purpose of this study was to report the outcome of adult patients admitted in 2015 to the LRU, which, to our knowledge, is the first intensive care unit in the United States that has been specifically created to provide care for patients requiring VV ECMO. Methods: Data was collected on all patients admitted to the LRU on VV ECMO between January 1st, 2015 and December 31st, 2015. Demographics, past medical history, pre-ECMO data, indication for VV ECMO as well as duration of ECMO and survival to decannulation and discharge were recorded. Means (+ standard deviation) and medians (interquartile range [IQR]) were reported when appropriate. Results: 49 patients were enrolled. Median age was 48 years [IQR 32-57]. Median PaO2/FiO2 ratio prior to cannulation was 66 (IQR 53-86). Median ventilator days prior to cannulation was 2 (IQR=1-4). Median time on VV ECMO for all patients was 311 hours (IQR=203-461). 38 (78%) patients were successfully decannulated with 35 (71%) patients surviving to hospital discharge. Conclusion: The use of VV ECMO for ARF/ARDS is increasing. We have demonstrated that a dedicated multi-disciplinary intensive care unit for the purpose of providing standardized care with specialized trained providers can improve survival to discharge for patients that require VV ECMO for ARF/ARDS. Evidence: Level IV. Prognostic/Epidemiological (C) 2017 Lippincott Williams & Wilkins, Inc.

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