Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: our single-center experience

Background: In this study, we present our five-year experience with venovenous extracorporeal membrane oxygenation for the treatment of acute respiratory distress syndrome. Methods: Between November 2010 and November 2015, 33 patients (24 males, 9 females; mean age: 48.6 +/- 14.7 years; range 19 to 76 years) with acute respiratory distress syndrome refractory to conventional therapy were supported with venovenous extracorporeal membrane oxygenation. The general indication for venovenous extracorporeal membrane oxygenation support was refractory hypoxia, hypercapnia, and respiratory acidosis, despite the optimization of conventional therapy. Detailed clinical data of the patients were retrospectively analyzed. Results: Cannulation was achieved via femoral-femoral veins in 24 patients (73%) and jugular-femoral veins in nine patients (27%). The median duration of venovenous extracorporeal membrane oxygenation support was 17 (range, 1 to 52) days. The most common complication was minor bleeding in six patients (18%). Eighteen patients (54.5%) were successfully weaned from venovenous extracorporeal membrane oxygenation support. Of these patients, 13 (39.4%) survived and were discharged from the hospital. Conclusion: Venovenous extracorporeal membrane oxygenation can be a life-saving treatment modality in patients with severe acute respiratory distress syndrome. Improved results may be provided with increased experience and an established standard protocol for the management of venovenous extracorporeal membrane oxygenation.