Observational studyCritical care (London, England)2026
Early trajectories of pulmonary hemodynamics in ARDS patients undergoing V-V ECMO: key determinants and prognostic impact.
Observational study in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary hypertension (PH) frequently complicates acute respiratory distress syndrome (ARDS) and contributes to right ventricular dysfunction and mortality. Veno-venous extracorporeal membrane oxygenation (V-V ECMO) may attenuate PH through improved gas exchange, yet pulmonary pressures often remain elevated. Data on the determinants and prognostic impact of PH in ECMO-supported ARDS are limited.
methodsWe performed a retrospective observational study of adult ARDS patients receiving V-V ECMO at a tertiary referral center between 2003 and 2024. Only patients monitored with a pulmonary artery catheter were included. Daily hemodynamic, ventilatory, and gas exchange data were prospectively collected. Determinants of mean pulmonary artery pressure (mPAP) were analyzed using a linear mixed-effects model. The association of (1) mPAP on the first day of ECMO and (2) the mPAP trajectory over the first 5 ECMO days—expressed as the patient-specific daily slope—with hospital mortality was assessed using logistic regression before and after adjustment for confounders.
resultsAmong 240 consecutive V-V ECMO patients, 225 had a pulmonary artery catheter and were analyzed. Median age was 51 years, 33% were female. The median mPAP during ECMO was 27 mmHg [23–32], with 91% of measurements exceeding 20 mmHg. Independent determinants of higher mPAP included intrapulmonary shunt fraction, lower venous pH, higher pulmonary artery occlusion pressure, increased PEEP, reduced respiratory system compliance, and longer ECMO duration. In contrast, higher venous partial pressure of oxygen and mixed venous oxygen saturation were associated with lower mPAP. mPAP on the first day of ECMO was not associated with hospital mortality. In contrast, the trajectory of mPAP during the first 5 days was independently associated with mortality (adjusted OR 1.89 per 1-mmHg/day increase, 95% CI 1.33–2.77, p < 0.001).
conclusionsPulmonary hypertension is highly prevalent in ARDS patients on V-V ECMO and reflects underlying disease severity. Early upward trajectories in mPAP, rather than the initial mPAP value, independently predicted higher mortality. Serial pulmonary pressure monitoring may provide relevant prognostic information and help guide management of pulmonary hemodynamics in ECMO-supported ARDS.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.