ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2022
Implementation of a regional multidisciplinary veno-venous extracorporeal membrane oxygenation unit improved survival: a historical cohort study.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05154071 (Impact of the Implementation of a Referral Veno-venous Extracorporeal Membrane Oxygenation Centre on Mortality), which is not on this map. Not yet cited in PubMed.
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Impact of the Implementation of a Referral Veno-venous Extracorporeal Membrane Oxygenation Centre on Mortality
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10 authors.
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Abstract
purposeVeno-venous extracorporeal membrane oxygenation (vvECMO) is a highly invasive technique with a high risk of mortality. Based on reports of improved outcomes in high-volume ECMO centers, we established a regional vvECMO unit. The objective of this study was to evaluate how the vvECMO unit affected patient mortality rates.
methodsThis was a historical cohort study of all patients admitted to Dijon University Hospital and supported by vvECMO between January 2011 and June 2021. Patients managed with the vvECMO unit were compared with patients managed with non-vvECMO units. The primary outcome was 90-day mortality.
resultsOf 172 patients treated using vvECMO, 69% were men, and the median [interquartile range] age was 59 [48-66] yr. Of the 172 patients, 35 were treated in the vvECMO unit and 137 were treated elsewhere (110/137 before the unit was established and 27/137 after). Ninety-day mortality was lower in patients managed in the vvECMO unit (15/35, 43% vs 92/137, 67%; P = 0.005). Within the vvECMO unit, mortality rates were also lower for the subgroup of patients managed after the specialized unit was established (15/35, 43% vs 20/27, 74%; P = 0.002). After adjusting for baseline severity of illness at vvECMO initiation, the vvECMO unit was independently associated with a lower 90-day mortality rate (hazard ratio, 0.41; 95% confidence interval, 0.21 to 0.80).
conclusionThe establishment of a vvECMO unit was associated with reduced 90-day mortality. This improved survival may relate to patient selection, more specialized mechanical ventilation support, and/or improvement of vvECMO care.
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