TABLE 3.
Extracorporeal Membrane Oxygenation-Related Complications in Patients Who Failed to Wean From Cardiopulmonary Bypass
| Variable | Total (n = 2,322) | Survivors (n = 1,039) | Nonsurvivors (n = 1,283) | p |
|---|---|---|---|---|
| ECMO circuit complications, n (%) | 906 (39) | 319 (31) | 587 (46) | < 0.001 |
| Mechanical problems | 245 (11) | 71 (7) | 174 (14) | < 0.001 |
| Clots in ECMO circuit | 696 (30) | 237 (23) | 459 (36) | < 0.001 |
| Air embolus | 90 (4) | 30 (3) | 60 (5) | 0.026 |
| Cannula problems | 119 (5) | 40 (4) | 79 (6) | 0.012 |
| CNS complications, n (%) | 409 (18) | 107 (10) | 302 (23) | < 0.001 |
| Seizures | 148 (6) | 43 (4) | 105 (8) | < 0.001 |
| Cerebral infarction or intracranial hemorrhage | 298 (13) | 81 (8) | 217 (17) | < 0.001 |
| Brain death | 30 (1) | 0 (0) | 30 (2) | < 0.001 |
| Cardiac complications, n (%) | 1,739 (75) | 722 (69) | 1,017 (79) | <0.001 |
| Cardiac arrhythmia requiring treatment | 403 (17) | 125 (12) | 278 (22) | < 0.001 |
| Cardiopulmonary resuscitation on ECMO | 74 (3) | 10 (1) | 64 (5) | < 0.001 |
| Cardiac tamponade | 243 (10) | 97 (9) | 146 (11) | 0.110 |
| Myocardial stun at echocardiography evaluation | 203 (9) | 63 (6) | 140 (11) | < 0.001 |
| Need for inotropic drugs | 1,503 (65) | 609 (59) | 894 (70) | < 0.001 |
| Hypertension requiring vasodilators | 369 (16) | 168 (16) | 201 (16) | 0.742 |
| Peripheral vascular complications, n (%) | 10 (0) | 0 (0) | 10 (1) | 0.003c |
| Pulmonary complications, n (%) | ||||
| Pneumothorax requiring treatment | 50 (2) | 17 (2) | 33 (3) | 0.122 |
| Pulmonary hemorrhage | 187 (8) | 39 (4) | 148 (11) | < 0.001 |
| Hemorrhagic complications (other than pulmonary), n (%) | ||||
| Cannulation site bleeding | 431 (19) | 166 (16) | 265 (21) | 0.004 |
| Surgical site bleeding | 1,099 (47) | 441 (42) | 658 (51) | < 0.001 |
| Gastrointestinal bleeding | 29 (1) | 7 (1) | 22 (2) | 0.025 |
| Hemolysisa, n (%) | 288 (12) | 103 (10) | 185 (14) | 0.001 |
| Disseminate intravascular coagulation, n (%) | 115 (5) | 26 (2) | 89 (7) | < 0.001 |
| Infectious complications, n (%) | ||||
| Culture proven infection | 215 (9) | 71 (7) | 144 (11) | < 0.001 |
| WBC count < 1,500/mL | 24 (1) | 5 (0) | 19 (1) | 0.018 |
| Renal complications, n (%) | ||||
| Renal failure | 299 (13) | 78 (7) | 221 (17) | < 0.001 |
| Serum creatinine 1.5–3.0 mg/dL | 169 (7) | 41 (4) | 128 (10) | < 0.001 |
| Serum creatinine > 3.0 mg/dL | 54 (2) | 20 (2) | 34 (3) | 0.249 |
| Dialysis required | 282 (12) | 61 (6) | 221 (17) | < 0.001 |
| Hemofiltration required | 650 (28) | 198 (19) | 452 (35) | < 0.001 |
| Metabolic complications, n (%) | ||||
| Arterial pH < 7.20 | 146 (6) | 39 (4) | 107 (8) | < 0.001 |
| Arterial pH > 7.60 | 111 (5) | 54 (5) | 57 (4) | 0.397 |
| Blood glucose < 40 mg/dL | 41 (2) | 14 (1) | 27 (2) | 0.168 |
| Blood glucose > 240 mg/dL | 368 (16) | 144 (14) | 224 (17) | 0.018 |
| Hyperbilirubinemiab | 132 (6) | 48 (5) | 84 (6) | 0.046 |
ECMO = extracorporeal membrane oxygenation.
aHemolysis is defined as plasma-free hemoglobin > 50 mg/dL.
bHyperbilirubinemia is defined as direct bilirubin > 2.0 mg/dL or total bilirubin > 15.0 mg/dL.
cFisher exact test.