Đánh giá hiệu quả ECMO ở bệnh nhân suy hô hấp cấp tiến triển nặng tại khoa hồi sức tích cực, Bệnh viện Quân y 175

Abstract

Objective: To evaluate the effectiveness of ECMO in the treatment of patients with severe progressive acute respiratory distress syndrome (ARDS).
Subjects and methods: This was a controlled interventional, longitudinal descriptive study including 102 patients diagnosed with severe ARDS. Among them, 51 patients were treated with ECMO and 51 patients received conventional treatment in the Intensive Care Unit of Military Hospital 175 from May 2023 to December 2024.
Results: A comparison between the 51 ECMO-treated patients and 51 control patients with severe ARDS revealed that the two groups were comparable in baseline characteristics (mean PaO₂/FiO₂: 58.3 vs. 56.7, p = 0.58). ECMO demonstrated superior outcomes, including a significantly lower 60-day mortality rate (33.3% vs. 49.0%, p = 0.047), a greater number of ventilator-free days (18.6 ± 7.3 vs. 12.3 ± 6.9, p = 0.002), and a more rapid improvement in multiple organ dysfunction (SOFA score on day 7: 6.4 ± 2.5 vs. 8.1 ± 2.7, p = 0.011; on day 14: 4.2 ± 1.9 vs. 6.7 ± 2.5, p = 0.004). However, the ECMO group had a higher incidence of bleeding requiring blood transfusion (45.1% vs. 25.5%, p = 0.032). Notably, the mortality rate among control patients who required rescue ECMO was as high as 61.5%.
Conclusion: ECMO is an effective treatment modality for patients with severe ARDS, offering improved 60-day survival, increased ventilator-free days, and earlier resolution of multiple organ failure. Nevertheless, careful consideration is required when indicating ECMO due to the elevated risk of bleeding complications.