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Mesenchymal Stem Cell-derived Exosomes: Are They Another Therapeutic Method for Extracorporeal Membrane Oxygenation-supported Acute Respiratory Distress Syndrome?

ABSTRACT:

SUBMITTER: Zhang L

PROVIDER: S-EPMC7706158 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Mesenchymal Stem Cell-derived Exosomes: Are They Another Therapeutic Method for Extracorporeal Membrane Oxygenation-supported Acute Respiratory Distress Syndrome?

Zhang Lanyu L Hei Feilong F

American journal of respiratory and critical care medicine 20201201 11

PMID: 32903027

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Project description:BackgroundThe application of prone position (PP) in acute respiratory distress syndrome (ARDS) supported by venovenous extracorporeal membrane oxygenation (VV-ECMO) is controversial.ObjectivesTo evaluate the safety and efficacy of application of PP during VV-ECMO in patients with ARDS.MethodsThis was a single-center, retrospective study of patients who met the Berlin definition of ARDS, and were supported with VV-ECMO. We divided the patients into two groups. The prone group included patients who were supported by VV-ECMO, and experienced at least one period of PP, while those without PP during VV-ECMO were defined as the supine group. Propensity score matching (PSM) at a ratio of 1:1 was introduced to minimize potential confounders. The primary outcomes were the complications of PP and the change of arterial oxygen pressure/fraction of the inspiration (PaO2/FiO2) ratio after PP. The secondary outcomes were hospital survival, ICU survival, and ECMO weaning rate.ResultsFrom April 2013 to October 2020, a total of 91 patients met the diagnostic criteria of ARDS who were supported with ECMO. 38 patients (41.8%) received at least one period of PP during ECMO, while 53 patients (58.2%) were maintained in supine position during ECMO. 22 minor complications were reported in the prone group and major complications were not found. The other ECMO-related complications were similar between two groups. The PaO2/FiO2 ratio significantly improved after PP compared with before (174.50 (132.40-228.25) mmHg vs. 158.00 (122.93-210.33) mmHg, p < 0.001). PSM selected 25 pairs of patients with similar characteristics. Hospital survival or ICU survival did not differ between the two groups (40% vs. 28%, p = 0.370; 40% vs. 32%, p = 0.556). Significant difference of ECMO weaning rate between two groups was not found (56% vs. 32%, p = 0.087).ConclusionsPP during VV-ECMO was safe and could improve oxygenation. A large-scale and well-designed RCT is needed in the future.

Dataset Information

Mesenchymal Stem Cell-derived Exosomes: Are They Another Therapeutic Method for Extracorporeal Membrane Oxygenation-supported Acute Respiratory Distress Syndrome?

Publications

Mesenchymal Stem Cell-derived Exosomes: Are They Another Therapeutic Method for Extracorporeal Membrane Oxygenation-supported Acute Respiratory Distress Syndrome?

Similar Datasets

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