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Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation
BACKGROUND: The 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, poss...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10429070/ https://www.ncbi.nlm.nih.gov/pubmed/37587413 http://dx.doi.org/10.1186/s12890-023-02591-5 |
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author | Orthmann, Thomas Ltaief, Zied Bonnemain, Jean Kirsch, Matthias Piquilloud, Lise Liaudet, Lucas |
author_facet | Orthmann, Thomas Ltaief, Zied Bonnemain, Jean Kirsch, Matthias Piquilloud, Lise Liaudet, Lucas |
author_sort | Orthmann, Thomas |
collection | PubMed |
description | BACKGROUND: The 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. METHODS: We 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. RESULTS: Fifty-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. CONCLUSIONS: DP on ECMO and longer MV duration before ECMO (in ARDS) are major, and potentially modifiable, factors influencing outcome during VV-ECMO. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02591-5. |
format | Online Article Text |
id | pubmed-10429070 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104290702023-08-17 Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation Orthmann, Thomas Ltaief, Zied Bonnemain, Jean Kirsch, Matthias Piquilloud, Lise Liaudet, Lucas BMC Pulm Med Research BACKGROUND: The 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. METHODS: We 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. RESULTS: Fifty-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. CONCLUSIONS: DP on ECMO and longer MV duration before ECMO (in ARDS) are major, and potentially modifiable, factors influencing outcome during VV-ECMO. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-023-02591-5. BioMed Central 2023-08-16 /pmc/articles/PMC10429070/ /pubmed/37587413 http://dx.doi.org/10.1186/s12890-023-02591-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Orthmann, Thomas Ltaief, Zied Bonnemain, Jean Kirsch, Matthias Piquilloud, Lise Liaudet, Lucas Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title | Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title_full | Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title_fullStr | Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title_full_unstemmed | Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title_short | Retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
title_sort | retrospective analysis of factors associated with outcome in veno-venous extra-corporeal membrane oxygenation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10429070/ https://www.ncbi.nlm.nih.gov/pubmed/37587413 http://dx.doi.org/10.1186/s12890-023-02591-5 |
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