초록접수 현황
| 17F-184 | 구연 미채택시 포럼 발표 |
Learning Curve of Veno-venous Extracorporeal Membrane Oxygenation Treatment: How Many Experiences are Necessary for Acceptable Results of Veno-venous Extracorporeal Membrane Oxygenation Treatment?
Jong Myung Park, Bong Soo Son, Hee Je Sim, Do Hyung Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Republic of Korea
Purpose : The procedure correction through learning curve evaluation is an important factor for achieving a stable success rate of treatment. In this study, we evaluate the number of cases required for a multidisciplinary ECMO team to obtain competence and to perform standard quality of VV ECMO.
Methods : We reviewed the clinical data of 142 patients who underwent VV ECMO for respiratory support between Aug 2011 and July 2017. The learning curve of multidisciplinary ECMO team was analyzed using cumulative sum (CUSUM) analysis. We defined success of ECMO treatment as successful ICU discharge, acceptable failure rate as 40%, and unacceptable failure rate as 60%. The Type I (false-positive) error and Type II (false-negative) error were set at 10% respectively.
Results : The overall success rate of ECMO treatment was 57.04% (81/142). Hospital discharge rate was 55.39% (77/139). CUSUM analysis indicated that a team’s performance begins to improve at case number 42 and cumulative failure chart suggested the ECMO team had achieved below unacceptable performance after 98 cases and crossed acceptable level after 110 cases. More than 110 cases of ECMO experiences were necessary for acceptable performance and stabilization of outcomes (Figure 1, 2).
Conclusion : We could progressively improve the success rate of VV ECMO after introduction of multidisciplinary team and achieved acceptable performance after more than 100 experiences through the process modification and optimization.
Methods : We reviewed the clinical data of 142 patients who underwent VV ECMO for respiratory support between Aug 2011 and July 2017. The learning curve of multidisciplinary ECMO team was analyzed using cumulative sum (CUSUM) analysis. We defined success of ECMO treatment as successful ICU discharge, acceptable failure rate as 40%, and unacceptable failure rate as 60%. The Type I (false-positive) error and Type II (false-negative) error were set at 10% respectively.
Results : The overall success rate of ECMO treatment was 57.04% (81/142). Hospital discharge rate was 55.39% (77/139). CUSUM analysis indicated that a team’s performance begins to improve at case number 42 and cumulative failure chart suggested the ECMO team had achieved below unacceptable performance after 98 cases and crossed acceptable level after 110 cases. More than 110 cases of ECMO experiences were necessary for acceptable performance and stabilization of outcomes (Figure 1, 2).
Conclusion : We could progressively improve the success rate of VV ECMO after introduction of multidisciplinary team and achieved acceptable performance after more than 100 experiences through the process modification and optimization.
책임저자: Do Hyung Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Gyeongsangnam-do, Republic of Korea
발표자: Jong Myung Park, E-mail : norlbit@yahoo.co.kr