Table 2.
ECMO and mechanical ventilation characteristics on the first day of ECMO, complications during ECMO, and clinical outcomes overall and according to 90-day survival status
| All patients (n=302) |
Survival status 90 days after ECMO |
p value | |||
|---|---|---|---|---|---|
| Alive (n=138) | Dead (n=164) | ||||
| Venovenous ECMO | 288 (95%) | 133 (96%) | 155 (95%) | 0·44 | |
| Femoro–jugular | 273 (90%) | 130 (94%) | 143 (87%) | 0·43 | |
| Femoro–femoral | 15 (5%) | 3 (2%) | 12 (7%) | 0·020 | |
| Diameter of the admission cannula, Fr | 25 (25–29) | 29 (25–29) | 25 (24–29) | 0·017 | |
| Diameter of the return cannula, Fr | 21 (19–21) | 21 (19–21) | 21 (19–21) | 0·28 | |
| Venoarterial or venoarterial–venous ECMO | 14 (5%) | 5 (4%) | 9 (5%) | 0·44 | |
| Femoro–femoral venoarterial ECMO | 10 (3%) | 3 (2%) | 7 (4%) | 0·21 | |
| Femoro–subclavian venoarterial ECMO | 1 (<1%) | 1 (1%) | 0 | NA | |
| Femoro–femoro–jugular venoarterial–venous ECMO | 3 (1%) | 1 (1%) | 2 (1%) | 0·56 | |
| ECMO blood flow, L/min | 5·0 (4·4–5·5); n=287 | 5·0 (4·3–5·4); n=134 | 5·0 (4·5–5·4); n=153 | 0·38 | |
| Sweep gas flow, L/min | 6 (4–8); n=285 | 5 (4–7); n=130 | 6 (4–8); n=155 | 0·0098 | |
| Membrane FmO2 | 100% (89–100); n=294 | 100% (90–100); n=135 | 100% (85–100); n=159 | 0·78 | |
| Ventilation parameters on ECMO day 1 | |||||
| FiO2, mm Hg | 80 (60–100); n=294 | 60 (50–100); n=136 | 95 (60–100); n=158 | 0·0005 | |
| PEEP, cm H2O | 12 (10–14); n=286 | 12 (10–14); n=133 | 12 (10–14); n=153 | 0·32 | |
| Tidal volume, mL/kg predicted bodyweight | 3·3 (2·2–4·5); n=281 | 2·9 (2·0–4·4); n=133 | 3·3 (2·2–4·6); n=148 | 0·46 | |
| Respiratory rate, breaths per min | 20 (14–22); n=264 | 20 (15–22); n=123 | 20 (14–21); n=141 | 0·088 | |
| Plateau pressure, cm H2O | 25 (24–27); n=269 | 25 (24–28); n=129 | 25 (24–27); n=140 | 0·46 | |
| Driving pressure, cm H2O | 13 (12–16); n=267 | 13 (12–15); n=127 | 14 (12–16); n=140 | 0·22 | |
| Prone positioning on ECMO | 193 (64%) | 95 (69%) | 98 (60%) | 0·10 | |
| High-dose corticosteroids on ECMO | 84/301 (28%) | 35/138 (25%) | 49/163 (30%) | 0·37 | |
| Tracheostomy | 59 (20%) | 51 (37%) | 8 (5%) | <0·0001 | |
| Complications during ECMO | |||||
| Renal replacement therapy | 130/301 (43%) | 38/137 (28%) | 92 (56%) | <0·0001 | |
| Pneumothorax | 23/270 (9%) | 7/133 (5%) | 16/137 (12%) | 0·059 | |
| Cardiac arrest | 46/270 (17%) | 8/133 (6%) | 38/137 (28%) | <0·0001 | |
| Thrombosis of ECMO circuit | 31 (10%) | 12 (9%) | 19 (12%) | 0·41 | |
| ECMO setting or insertion change* | 39/301 (13%) | 8 (6%) | 31/163 (19%) | <0·0001 | |
| Repeat ECMO needed after decannulation | 16/295 (5%) | 5/137 (4%) | 11/158 (7%) | 0·21 | |
| Severe thrombocytopenia (<50 × 109 cells per L) | 55 (18%) | 17 (12%) | 38 (23%) | 0·014 | |
| Massive haemorrhage requiring transfusion | 115/270 (43%) | 41/133 (31%) | 74/137 (54%) | <0·0001 | |
| Intracranial haemorrhage | 27/223 (12%) | 5/86 (6%) | 22/137 (16%) | 0·0098 | |
| Ischaemic stroke | 6/220 (3%) | 1/86 (1%) | 5/134 (4%) | 0·26 | |
| Pulmonary embolism | 53/294 (18%) | 15/132 (11%) | 38/162 (23%) | 0·0073 | |
| Antibiotic-treated ventilator-associated pneumonia | 257/301 (85%) | 119 (86%) | 138/163 (85%) | 0·61 | |
| Antibiotic-treated cannula infection | 45/301 (15%) | 27 (20%) | 18/163 (11%) | 0·038 | |
| At least 1 antibiotic-treated bacteraemia episode | 148/300 (49%) | 65 (47%) | 83/162 (51%) | 0·78 | |
| ECMO duration, days | 14 (8–26); n=296 | 17 (10–27); n=132 | 12 (6–25); n=164 | 0·081 | |
| Invasive mechanical ventilation duration, days | 28 (15–44); n=287 | 33 (25–50); n=124 | 20 (12–37); n=163 | <0·0001 | |
| ICU length of stay, days | 30 (17–47); n=289 | 39 (29–57); n=127 | 21 (13–37); n=162 | <0·0001 | |
| Cause of death | |||||
| Multiorgan failure | 53 (18%) | .. | 53 (32%) | .. | |
| Septic shock | 47 (16%) | .. | 47 (29%) | .. | |
| Intracranial haemorrhage | 22 (7%) | .. | 22 (13%) | .. | |
| Haemorrhagic shock | 11 (4%) | .. | 11 (7%) | .. | |
| Cardiovascular shock | 9 (3%) | .. | 9 (5%) | .. | |
| Pulmonary embolism | 9 (3%) | .. | 9 (5%) | .. | |
| Ischaemic stroke | 5 (2%) | .. | 5 (3%) | .. | |
| Other | 8 (3%) | .. | 8 (5%) | .. | |
Data are median (IQR) or median (IQR); n (where data are not available for all patients), n (%), or n/N (%). ECMO=extracorporeal membrane oxygenation. FiO2=fraction of inspired oxygen. FmO2=membrane fraction of oxygen. Fr=French. ICU=intensive care unit. NA=not applicable. PEEP=positive end-expiratory pressure.
*
Includes ECMO cannulation switches from venoarterial to venovenous, and venoarterial to venous–arteriovenous.