Extracorporeal membrane oxygenation for acute lung injury in idiopathic inflammatory myopathies-a potential lifesaving intervention.
| Title: | Extracorporeal membrane oxygenation for acute lung injury in idiopathic inflammatory myopathies-a potential lifesaving intervention. |
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| Authors: | Zheng B; Division of Rheumatology, University of British Columbia, Vancouver, Canada.; Division of Rheumatology, McGill University Health Centre, Montreal, Canada.; Eline E; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Xu L; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Huang K; Division of Rheumatology, University of British Columbia, Vancouver, Canada.; Hermans G; Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium.; Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.; Perch M; Division of Lung Transplantation, Heart Center, Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Samoukovic G; Division of Rheumatology, McGill University Health Centre, Montreal, Canada.; De Langhe E; Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium.; Dastmalchi M; Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.; Christopher-Stine L; Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Diederichsen LP; Department of Rheumatology, Odense University Hospital, Odense, Denmark.; Department of Rheumatology, Rigshospitalet, Copenhagen, Denmark.; Leclair V; Division of Rheumatology, Jewish General Hospital, Montreal, Canada.; Lady Davis Institute for Medical Research, Montreal, Canada. |
| Source: | Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2025 Apr 01; Vol. 64 (4), pp. 2204-2208. |
| Publication Type: | Journal Article; Multicenter Study; Research Support, N.I.H., Extramural |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999- |
| MeSH Terms: | Extracorporeal Membrane Oxygenation*/methods ; Myositis*/complications ; Acute Lung Injury*/therapy ; Acute Lung Injury*/etiology ; Acute Lung Injury*/mortality ; Respiratory Distress Syndrome*/therapy ; Respiratory Distress Syndrome*/etiology ; Respiratory Distress Syndrome*/mortality; Humans ; Female ; Middle Aged ; Male ; Adult ; Treatment Outcome ; Retrospective Studies ; Intensive Care Units |
| Abstract: | Objectives: Idiopathic inflammatory myopathies (IIM) can present with acute IIM-related lung injury and respiratory failure, leading to a high mortality risk in intensive care units (ICU). Extracorporeal membrane oxygenation (ECMO) in acute respiratory distress syndrome can be lifesaving. We aimed to report a case series of IIM patients that received ECMO.; Methods: Patients with IIM from tertiary care centres in Belgium, Canada, Denmark, USA and Sweden who underwent ECMO were reviewed to describe clinical characteristics, disease outcomes and hospitalization course. Clinical characteristics at admission and during ICU stay including ECMO complications and mortality causes were summarized.; Results: The study included 22 patients (50% female, mean ± SD age at admission 47 ± 12 years) with anti-MDA5 positive dermatomyositis (68%), anti-synthetase syndrome (14%), polymyositis (9%), overlap myositis (5%) and non-MDA5 dermatomyositis (5%). Patients had low comorbidity scores and 46% had received immunosuppression before their ICU admission. Eight (36%) patients died in the ICU, six (27%) were bridged to recovery and eight (36%) were bridged to transplant. When comparing patients bridged to recovery and those who died in the ICU, those who died were older (P = 0.03) and had higher median Charlson comorbidity index scores (P = 0.05). Both groups had similar frequencies of ECMO-related complications (33% vs 50%, P = 0.94).; Conclusion: In the patients exposed to ECMO in this case series, 14 were successfully bridged to recovery or transplant, while 8 died in the ICU. Large studies are needed to collect data on clinical outcomes in patients with IIM-ILD exposed to ECMO to identify the best candidates for the intervention.; (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.) |
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| Grant Information: | T32 GM136577 United States GM NIGMS NIH HHS |
| Contributed Indexing: | Keywords: anti-MDA5 antibody; dermatomyositis; extracorporeal membrane oxygenation; lung transplantation; rapid progressive interstitial lung disease |
| Entry Date(s): | Date Created: 20240525 Date Completed: 20250403 Latest Revision: 20260513 |
| Update Code: | 20260514 |
| PubMed Central ID: | PMC11962946 |
| DOI: | 10.1093/rheumatology/keae311 |
| PMID: | 38796679 |
| Database: | MEDLINE |
Journal Article; Multicenter Study; Research Support, N.I.H., Extramural