• Zachary N Kon, Siamak Dahi, Charles F Evans, Kimberly A Byrnes, Gregory J Bittle, Brody Wehman, Raymond P Rector, Brian M McCormick, Daniel L Herr, Pablo G Sanchez, Si M Pham, and Bartley P Griffith.
• Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: zkon@smail.umaryland.edu.
• Ann. Thorac. Surg. 2015 Dec 1; 100 (6): 2059-63.

BackgroundGiven substantial advances in venovenous extracorporeal membrane oxygenation (ECMO) technology, long-term support is increasingly feasible. Although the benefits of short-term ECMO as a bridge to recovery in acute respiratory distress syndrome (ARDS) are well described, the utility and outcomes of long-term support remain unclear.MethodsPatients requiring ECMO for ARDS between January 2009 and November 2012 were retrospectively reviewed and analyzed separately for those requiring ECMO support for less than 3 weeks or for 3 weeks or longer. Demographic factors, ECMO variables, and outcomes were assessed.ResultsFifty-five patients with ARDS received ECMO during the study period, with 11 patients requiring long-term ECMO support and a median duration of 36 (interquartile range: 24 to 68) days. Recovery was the initial goal in all patients. Pre-ECMO mechanical ventilatory support, indices of disease severity, and the ECMO cannulation strategy were similar between the two groups. Eight (73%) patients receiving long-term support were bridged to recovery, and 1 patient was bridged to transplantation after a refractory course. Eight (73%) patients receiving long-term support and 25 (57%) patients receiving short-term support survived to 30 days and hospital discharge.ConclusionsPreviously, long-term ECMO support was thought to be associated with unfavorable outcomes. This study, however, may provide support for the efficacy of ECMO support even for 3 weeks or more as a bridge to recovery or transplantation.Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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