Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation

BMC Pulmonary Medicine

Research

Zied Ltaief¹  Jean Bonnemain¹  Lucas Liaudet²  Lise Piquilloud²  Thomas Orthmann²  Matthias Kirsch³ 

[1] The Department of Adult Intensive Care Medicine, University Hospital Medical Center, 1011, Lausanne, Switzerland;The Department of Adult Intensive Care Medicine, University Hospital Medical Center, 1011, Lausanne, Switzerland;The Faculty of Biology and Medicine, University of Lausanne, 1011, Lausanne, Switzerland;The Faculty of Biology and Medicine, University of Lausanne, 1011, Lausanne, Switzerland;The Department of Cardiac Surgery, University Hospital Medical Center, 1011, Lausanne, Switzerland;

关键词: Veno-venous extracorporeal membrane oxygenation;    Acute respiratory failure;    Acute respiratory distress syndrome;    Mechanical ventilation;    Driving pressure;   

DOI  :  10.1186/s12890-023-02591-5

 received in 2023-04-14, accepted in 2023-07-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe outcome of Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) in acute respiratory failure may be influenced by patient-related factors, center expertise and modalities of mechanical ventilation (MV) during ECMO. We determined, in a medium-size ECMO center in Switzerland, possible factors associated with mortality during VV-ECMO for acute respiratory failure of various etiologies.MethodsWe retrospectively analyzed all patients treated with VV-ECMO in our University Hospital from 2012 to 2019 (pre-COVID era). Demographic variables, severity scores, MV duration before ECMO, pre and on-ECMO arterial blood gases and respiratory variables were collected. The primary outcome was ICU mortality. Data were compared between survivors and non-survivors, and factors associated with mortality were assessed in univariate and multivariate analyses.ResultsFifty-one patients (33 ARDS, 18 non-ARDS) were included. ICU survival was 49% (ARDS, 39%; non-ARDS 67%). In univariate analyses, a higher driving pressure (DP) at 24h and 48h on ECMO (whole population), longer MV duration before ECMO and higher DP at 24h on ECMO (ARDS patients), were associated with mortality. In multivariate analyses, ECMO indication, higher DP at 24h on ECMO and, in ARDS, longer MV duration before ECMO, were independently associated with mortality.ConclusionsDP on ECMO and longer MV duration before ECMO (in ARDS) are major, and potentially modifiable, factors influencing outcome during VV-ECMO.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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