EXTRACORPOREAL MEMBRANE-OXYGENATION FOR RESPIRATORY-FAILURE

We report herein our experience with extracorporeal membrane oxygenati on (ECMO) for respiratory failure over a 3-year period. ECMO was emplo yed in seven patients: in five for respiratory failure caused by adult respiratory distress syndrome (ARDS), Goodpasture's syndrome, hypoxia after ventricular septal defect closure, interstitial pneumonia, or l ung metastasis from choriocarcinoma; and in two for tracheal obstructi on. Nafamostat mesilate was used as the main anticoagulant with a smal l amount of heparin. The period of ECMO support for the five patients with respiratory failure ranged from 54 to 251 h, with an average time of 125 h. Five of the seven patients were able to be weaned from ECMO , and the two who had tracheal obstruction survived. The other three p atients who were weaned from ECMO died of underlying diseases or compl ications 1-25 days after weaning. The complications which occurred dur ing ECMO support were an abnormal electroencephalogram, multiple organ failure, and mediastinitis. Thus, we conclude that ECMO needs to be i nduced early to obtain a better outcome in patients with respiratory f ailure, and that it is particularly effective for transient airway obs truction.