Systemic inflammatory response syndrome (SIRS) after extracorporeal membrane oxygenation (ECMO): Incidence, risks and survivals

• Published in: Heart & lung Vol. 45; no. 5; pp. 449 - 453
• Main Authors: Thangappan, Karthik, Cavarocchi, Nicholas C., MD, Baram, Michael, MD, Thoma, Brandi, PhamD, Hirose, Hitoshi, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2016; Elsevier Science Ltd
• Subjects: Cardiovascular; Clinical outcomes; Critical Care; ECMO; Extracorporeal Membrane Oxygenation - adverse effects; Female; Humans; Incidence; Infection; Inflammatory diseases; Male; Medical procedures; Middle Aged; Outcomes; Pennsylvania - epidemiology; Pulmonary/Respiratory; Retrospective Studies; Risk assessment; Risk Assessment - methods; Risk Factors; SIRS; Survival; Survival analysis; Survival Rate - trends; Systemic Inflammatory Response Syndrome - epidemiology; Systemic Inflammatory Response Syndrome - etiology; Treatment Outcome; United States > US; ECMO; model for end-stage liver disease; white blood cell; acute physiology and chronic health evaluation; Survival; Outcomes; extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation; Infection; SIRS; systemic inflammatory response syndrome; MELD; SAPS; WBC; extracorporeal membrane oxygenation; E-CPR; APACHE; simplified acute physiology score
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2016.06.004

Abstract Introduction Systemic inflammatory response syndrome (SIRS) is frequently observed after extracorporeal membrane oxygenation (ECMO) decannulation; however, these issues have not been investigated well in the past. Methods Retrospective chart review was performed to identify post-ECMO SIRS phenomenon, defined by exhibiting 2/3 of the following criteria: fever, leukocytosis, and escalation of vasopressors. The patients were divided into 2 groups: patients with documented infections (Group I) and patients with true SIRS (Group TS) without any evidence of infection. Survival and pre-, intra- and post-ECMO risk factors were analyzed. Results Among 62 ECMO survivors, 37 (60%) patients developed the post-ECMO SIRS phenomenon, including Group I ( n  = 22) and Group TS ( n  = 15). The 30-day survival rate of Group I and TS was 77% and 100%, respectively ( p  = 0.047), although risk factors were identical. Conclusions SIRS phenomenon after ECMO decannulation commonly occurs. Differentiating between the similar clinical presentations of SIRS and infection is important and will impact clinical outcomes.