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Veno-arterial extracorporeal membrane oxygenation versus standard medical management for massive pulmonary embolism.
- Source :
-
Perfusion . Sep2024, Vol. 39 Issue 6, p1190-1196. 7p. - Publication Year :
- 2024
-
Abstract
- Purpose: There is limited research on the use and outcomes of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment for massive pulmonary embolism (PE). This study compared VA-ECMO treatment for massive PE versus patients treated medically. Materials and methods: Patients diagnosed with massive PE at one hospital system were reviewed. VA-ECMO and non-ECMO groups were compared by t test and Chi-square. Mortality risk factors were identified by logistic regression. Survival was assessed by Kaplan Meier and propensity matching of groups. Results: Ninety-two patients were included (22 VA-ECMO and 70 non-ECMO). Age (OR 1.08, 95% CI 1.03–1.13), arterial SBP (OR 0.97, 95% CI 0.94–0.99), albumin (OR 0.3, 95% CI 0.1–0.8), and phosphorus (OR 2.0, 95% CI 1.4–3.17) were independently associated with 30-day mortality. Alkaline phosphate (OR 1.03, 95% CI 1.01–1.05) and SOFA score (OR 1.3, 95% CI 1.06–1.51) were associated with 1-year mortality. Propensity matching showed no difference in 30-day (59% VA-ECMO versus 72% non-ECMO, p = 0.363) or 1-year survival (50% VA-ECMO versus 64% non-ECMO, p = 0.355). Conclusions: Patients treated with VA-ECMO for massive PE and medically treated patients have similar short- and long-term survival. Further research is needed to define clinical recommendations and benefits of intensive therapy such as VA-ECMO in this critically ill population. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PULMONARY embolism
*EXTRACORPOREAL membrane oxygenation
*T-test (Statistics)
*CRITICALLY ill
*PATIENTS
*RESEARCH funding
*MULTIPLE regression analysis
*CHI-squared test
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*ODDS ratio
*STATISTICS
*COMPARATIVE studies
*CONFIDENCE intervals
*DATA analysis software
Subjects
Details
- Language :
- English
- ISSN :
- 02676591
- Volume :
- 39
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Perfusion
- Publication Type :
- Academic Journal
- Accession number :
- 179940904
- Full Text :
- https://doi.org/10.1177/02676591231182247