Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 5, Number 2, February 2014, pages 83-88

Use of a Daily Lung Compliance Evaluation to Track Progress on ECMO: Successful Use in a Patient With Cystic Fibrosis

Figures

Figure 1.
Figure 1. Daily lung compliance trial (DLCT) gives insight to pulmonary improvement on ECMO. Pulmonary pressures (A) and lung compliance (B) during DLCT. Reading (circles) were obtained 30 minutes after initiating DLCT. Cdyn: dynamic compliance; Cstat: static compliance; Paw: mean airway pressure; PEEP: positive end-expiratory pressure; PIP: peak inspiratory pressure; Pplat: plateau pressure.
Figure 2.
Figure 2. Radiographic course of cystic fibrosis patient while on ECMO. ICUD: ICU day; MVD: mechanical ventilation day; ECMOD: ECMO day; HD: hospital day.

Tables

Table 1. Survival Over Time for CF Patients in ELSO Database by Transplant status*
 
Non-Transplant RelatedTransplant Related
% Reflects the percentage of patients in each year in by transplantation status; *Reflects only first ECMO run of CF patients; †Mean survival is the overall survival during the specified time interval. CF: cystic fibrosis; ELSO: Extracorporeal Life Support Organization; ECMO: extracorporeal membrane oxygenation.
1998 - 20001/2 (50%)4/9 (44%)
2001 - 20031/3 (33%)5/10 (50%)
2004 - 20065/12 (42%)0/1 (0%)
Mean Survival prior 2007†7/17 (41%)9/20 (45%)
2007 - 20092/8 (25%)3/3 (100%)
2010 - 201211/23 (48%)13/20 (65%)
Mean Survival after 2007†13/31 (42%)16/23 (70%)

 

Table 2. Survival of Non-Transplant CF Patients Requiring ECMO Based on Clinical Characteristics
 
CharacteristicsSurvival
% Reflect the percentage of survival in each group; CF: cystic fibrosis; ECMO: extracorporeal membrane oxygenation; MV: mechanical ventilation time; HFOV: high frequency oscillatory ventilation.
Total non-transplant20/48 (42%)
Age
  < 12 years6/14 (43%)
  12 - 17 years5/7 (71%)
  18 - 35 years5/20 (25%)
  > 35 years4/7 (57%)
Clinical characteristics
  vasoactive support15/33 (45%)
  HFOV6/13 (46%)
  dialysis/renal failure3/6 (50%)
  sepsis5/16 (31%)
Pre-ECMO MV time
  ≤ 12 hours0/7 (0%)
  12 - 48 hours15/20 (75%)
  > 2 days2/13 (15%)
ECMO type
  Veno-venous14/27 (52%)
  Veno-arterial6/20 (30%)