Inflammatory and microbiological associations with near-fatal asthma requiring extracorporeal membrane oxygenation

Patel, Sunil; Shah, Neeraj M.; Malhotra, Akanksha M.; Lockie, Christopher; Camporota, Luigi; Barrett, Nicholas; Kent, Brian D.; Jackson, David J.

incidence of positive bacterial isolates. Compared to the mechanical ventilation group, days on mechanical ventilation were significantly greater in the ECMO cohort (13±12 versus 5±8 days, p=0.006). In addition, length of stay (LoS) in the ICU (15±10 versus 5±7 days, p=0.033) and in hospital (22±17 versus 12±16 days, p<0.001) were significantly longer in the ECMO group. Higher CRP levels on admission to hospital were associated with a more prolonged hospital and ICU stay in the mechanical ventilation group only ( p<0.001). All ECMO patients survived to hospital discharge; however, two mechanically ventilated patients died during their ICU admission. In this retrospective review of adult asthmatics admitted to intensive care for a near-fatal acute exacerbation, we report that the requirement for ECMO was associated with younger age, female sex and the presence of either fungal or rhinoviral infection in the lower airway. In addition, a higher white cell count, a more profound degree of hypercapnia and acidaemia, as well as an increased LoS in the ICU and hospital overall, were observed in those requiring ECMO support.