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Early vvECMO implantation may be associated with lower mortality in ARDS

Authors :
Peter Rosenberger
Lisa Korell
Helene A. Haeberle
Valbona Mirakaj
Alice Bernard
Linyan Tang
Andreas Körner
Peter Martus
Michael Koeppen
Source :
Respiratory Research, Vol 24, Iss 1, Pp 1-9 (2023)
Publication Year :
2023
Publisher :
BMC, 2023.

Abstract

Abstract Background Venovenous extracorporeal membrane oxygenation (vvECMO) is used to treat hypoxia in patients with severe acute respiratory distress syndrome (ARDS). Nevertheless, uncertainty exists regarding the optimal timing of initiation of vvECMO therapy. We aimed to investigate the association between number of days of invasive mechanical ventilation (IMV) prior to vvECMO implantation and mortality. Methods In this retrospective observational study, we included patients treated at an academic intensive care unit with vvECMO for severe ARDS. The primary outcome was all-cause 28-day mortality. We conducted a multivariate logistic regression analysis to estimate the association between number of days of IMV prior to vvECMO implantation and mortality after adjustment for confounders. Results Out of 274 patients who underwent ECMO for severe ARDS, 158 patients (median age: 58 years) with relevant data were included in the analysis. The mean duration of IMV prior to vvECMO was significantly shorter in survivors than in nonsurvivors [survivors median: 1; interquartile range: 1–3; non-survivors median 4; interquartile range: 1–5.75; p = 0.0001). Logistic regression showed an association between the duration of ventilation prior to vvECMO and patient mortality. The odds ratio for the all-cause 28-day mortality and in-hospital mortality was significantly reduced in patients who received vvECMO within the first 5 days of IMV. Conclusions Early vvECMO implantation may be associated with lower mortality in ARDS.

Details

Language :
English
ISSN :
1465993X
Volume :
24
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Respiratory Research
Publication Type :
Academic Journal
Accession number :
edsdoj.24e5ae3c298b4155948638efd2503382
Document Type :
article
Full Text :
https://doi.org/10.1186/s12931-023-02541-z