Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience

BackgroundAdults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy.MethodsThe Extracorporeal Life Support Organization Registry was queried for patients aged ≥21 years with diagnoses of malignancy or hematopoietic stem cell transplantation.ResultsSeventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation. Patients required ECLS primarily for pulmonary support (n = 54). The median duration of ECLS was 4.1 days. Overall, 44 patients (61%) died on ECLS, 23 (32%) survived to hospital discharge, and 5 (7%) survived ECLS but died before discharge. Risk factors for death include pulmonary support as reason for ECLS, impaired lung function before ECLS, and development of infection.ConclusionsAdults with cancer can be offered ECLS with a small but real expectation for survival. Impaired pulmonary status and the development of infections are associated with death.