Table 2.
Patients’ ECMO management and in-ICU complications according to their pregnancy status on ECMO
| All (N = 24) | Ongoing pregnancy on ECMO (N = 11) | Delivery before ECMO (N = 13) | p | |
|---|---|---|---|---|
| Type of ECMO support | ||||
| Venovenous ECMO | 22 (92) | 10 (91) | 12 (92) | 0.90 |
| Venoarterial ECMO | 2 (8) | 1 (9) | 1 (8) | 0.90 |
| Switch from VV to VA | 1 (4) | 1 (9) | 0 (0) | 0.27 |
| Switch from VV to V-AV | 3 (13) | 0 (0) | 3 (23) | 0.09 |
| Switch from VA to VV | 1 (4) | 0 (0) | 1 (8) | 0.35 |
| ECMO-related complications | ||||
| Clogged circuit/membrane requiring a change | 1 (4) | 1 (9) | 0 (0) | 0.26 |
| At least one circuit change | 10 (42) | 2 (18) | 8 (62) | 0.03 |
| Major bleeding | ||||
| Cannula bleeding | 12 (50) | 5 (45) | 7 (54) | 0.66 |
| Obstetrical bleeding* | 8 (33) | 2 (18) | 6 (46) | 0.05 |
| Number of RBC transfusions | 7 (0–50) | 7 (0–50) | 7 (2–23) | 0.11 |
| Stroke | 2 (8) | 1 (9) | 1 (8) | 0.90 |
| Pneumothorax on ECMO | 8 (33) | 2 (18) | 6 (46) | 0.14 |
| Acute kidney injury | ||||
| KDIGO ≥ 2 | 9 (38) | 3 (27) | 6 (46) | 0.34 |
| Renal replacement therapy | 9 (38) | 2 (18) | 6 (46) | 0.14 |
| ≥ 1 antibiotic-treated VAP | 14 (58) | 4 (36) | 10 (77) | 0.04 |
| ≥ 1 antibiotic-treated bacteremia episode(s) | 8 (33) | 0 (0) | 8 (62) | < 0.01 |
| Tracheostomy | 10 (42) | 3 (27) | 7 (54) | 0.19 |
| Tidal volume on ECMO Day 1, ml/kg PBW | 3.2 (1.0–7.4) | 3.1 (1.0–6.3) | 3.2 (1.7–4.0) | 0.93 |
| On ECMO | ||||
| Neuromuscular blockade | 21 (88) | 10 (91) | 11 (85) | 0.64 |
| Prone positioning | 8 (33) | 3 (27) | 5 (38) | 0.56 |
| Inhaled nitric oxide | 3 (13) | 1 (9) | 2 (15) | 0.64 |
| Hypothermia | 1 (4) | 1 (9) | 0 (0) | 0.26 |
| Beta-blockers | 2 (8) | 1 (9) | 1 (8) | 0.90 |
| Antenatal corticosteroid therapy | 14 (58) | 7 (63) | 7 (54) | 0.68 |
Data are expressed as n (%) or median (range)
ECMO extracorporeal membrane oxygenation; ICU intensive care unit; VV venovenous; VA venoarterial; V-AV veno-arteriovenous; RBC red blood cells; KDIGO Kidney Disease Improving Global Outcomes; PBW Predicted Body Weight
*Uterine bleedings or abdominal parietal hematoma or hemoperitoneum