0
Critical Care |

A Descriptive Study of Pulmonary Function Testing and Chest Computed Tomography in Survivors of Veno-Venous Extracorporeal Membrane Oxygenation

Matthew Miles, DO; Dorothea Watson, DO; Rita Pechulis, MD
Author and Funding Information

Lehigh Valley Health Network, Allentown, PA


Chest. 2015;148(4_MeetingAbstracts):307A. doi:10.1378/chest.2269207
Text Size: A A A
Published online

Abstract

SESSION TITLE: Mechanical Ventilation and Respiratory Failure Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Veno-Venous Extracorporeal Membrane Oxygenation (VV ECMO) is a therapy for refractory hypoxemia due to Acute Respiratory Distress Syndrome (ARDS). Previous studies of ARDS patients not treated with VV ECMO described radiographic changes post ARDS which showed reticular CT changes mostly in anterior distribution.1 A longitudinal study of patients five years post ARDS showed near normal pulmonary function tests (PFTs).2 Little is known about the radiographic and functional pulmonary recovery of the most severe subgroup of ARDS patients who required ECMO.

METHODS: This is a single center descriptive study to evaluate radiographic changes and PFTs in post ARDS patients treated with VV ECMO. Three female and two male adults with ARDS, averaging 46.4 ± 7 years were included. There were two cases due to Influenza A H1N1, two due to community acquired pneumonia, and one of unknown etiology. All presented with severe, persistent hypoxia with a PF ratio <100 requiring VV ECMO.

RESULTS: The average time on VV ECMO was 35.25 days (range 12-71 days) and the average hospital stay was 72.75 days (range 33-154 days). All patients required tracheostomy and were discharged to a long-term acute care hospital where they were weaned off of mechanical ventilation. Initial chest CT scans showed bilateral parenchymal consolidations, ground glass opacities, air trapping, and in one case spontaneous pneumothorax. Chest CT follow up averaged 168 days post ECMO; while significant improvement was seen in consolidations and ground glass opacities, there remained abnormal persistent interstitial opacities. PFT follow up averaged 176 days post ECMO for four patients, one patient did not have follow up PFTs. The PFTs showed significantly decreased TLC (averaging 68% ± 11% predicted), DLCO (averaging 36% ± 8% predicted), and FEV1 (averaging 64% ± 14% predicted).

CONCLUSIONS: In this descriptive study, patients without previous pulmonary disease who presented with severe ARDS requiring VV ECMO, had significant residual pulmonary abnormalities on PFT’s including decreased DLCO, TLC, and FEV1 and persistent chest CT abnormalities including interstitial opacities. Further research is needed to evaluate long-term recovery in post ARDS VV ECMO patients.

CLINICAL IMPLICATIONS: Patients with severe ARDS post V-V ECMO had significant residual defects on follow up PFT and chest CT scans.

DISCLOSURE: The following authors have nothing to disclose: Matthew Miles, Dorothea Watson, Rita Pechulis

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543