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Low volume ECMO results study.

Christopher J Joyce1,2, David A Cook1,2,3, James Walsham1,2

  • 1Intensive Care, Princess Alexandra Hospital, Brisbane, QLD, Australia.

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|December 4, 2023
PubMed
Summary
This summary is machine-generated.

Extracorporeal membrane oxygenation (ECMO) in two Australian hospitals showed survival rates comparable to established benchmarks. This study analyzed patient outcomes across respiratory, cardiac, and eCPR categories, demonstrating effective ECMO utilization in low-volume centers.

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Area of Science:

  • Cardiovascular Sciences
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life support technology used in critical care.
  • Low-volume centers face challenges in maintaining ECMO expertise and achieving optimal outcomes.
  • Benchmarking outcomes against established scores is crucial for quality assessment.

Purpose of the Study:

  • To evaluate the ECMO experience at two Australian tertiary hospitals.
  • To compare observed patient mortality with predicted mortality using validated scoring systems.
  • To assess the performance of ECMO in respiratory failure, cardiac failure, and extracorporeal cardiopulmonary resuscitation (eCPR) patient groups.

Main Methods:

  • A case series design was employed, analyzing data from adult patients (>18 years) treated with ECMO.
  • Patients were stratified into respiratory failure, cardiac failure, and eCPR cohorts.
  • Observed mortality was compared against predictions from the Respiratory ECMO Survival Prediction (RESP) score, Survival after Veno-arterial ECMO (SAVE) score, modified SAVE score, and Extracorporeal Life Support Organization (ELSO) Registry benchmarks for eCPR.

Main Results:

  • Over 10 years, 86 patients received ECMO. Respiratory failure group (49 patients) had 8 deaths, significantly lower than predicted by the RESP score (P < 0.001).
  • Cardiac failure group (27 patients) had 9 deaths, lower than predicted by the standard SAVE score (P < 0.001) but consistent with the modified SAVE score (P > 0.05).
  • The eCPR group (10 patients) had 7 deaths, aligning with ELSO Registry predictions.

Conclusions:

  • Mortality rates at these two low-volume ECMO centers were not inferior to established benchmarks.
  • The findings suggest that effective ECMO care can be delivered even in centers with lower case volumes.
  • This study provides valuable insights into ECMO outcomes and performance in the Australian context.