Japan Intensive Care Consortium: Nationwide Effort for Extracorporeal Membrane Oxygenation Care Optimization and...

Area of Science:

• Critical Care Medicine
• Cardiovascular Research
• Pulmonology

Background:

• Extracorporeal membrane oxygenation (ECMO) is crucial for severe cardiogenic shock or respiratory failure unresponsive to standard treatments.
• Despite technological advances, ECMO is associated with significant complications like infections, renal dysfunction, and post-intensive care syndrome, contributing to high mortality.
• Existing registries offer limited granular data on infection management, rehabilitation, and specific ECMO care aspects.

Purpose of the Study:

• To establish a comprehensive multicenter study in Japan, the ECMO NEXT study aims to address critical data gaps in ECMO research.
• The study seeks to optimize ECMO care and excellence through nationwide collaborative efforts.
• To provide high-resolution data for improving intensive care unit (ICU) management and post-ECMO recovery.

Main Methods:

• A multicenter, retrospective cohort study involving 22 Japanese healthcare institutions from January 2018 to December 2023.
• Inclusion criteria: Adults (≥18 years) undergoing ECMO in the ICU.
• Focus on six key themes: post-decannulation fever, infection epidemiology, ventilator settings, ECMO-associated acute kidney injury and electrolyte abnormalities, rehabilitation practices, and venoarterial ECMO in specific shock scenarios. Data collected via a standardized electronic case report form on REDCap; statistical analyses including propensity score methods will be employed.

Main Results:

• Data collection is ongoing, focusing on detailed clinical courses, laboratory results, rehabilitation interventions, and patient outcomes.
• The study is designed to yield high-resolution data crucial for identifying risk factors and optimizing management strategies.
• Propensity score-based analyses will be utilized to adjust for confounders and determine attributable risks for various ECMO-related complications and outcomes.

Conclusions:

• The ECMO NEXT study is poised to provide unprecedented high-resolution data on ECMO patient care in Japan.
• This research will significantly contribute to addressing existing gaps in ECMO literature, particularly concerning ICU management and long-term patient recovery.
• Findings are expected to inform clinical practice, enhance patient outcomes, and guide future research in ECMO therapy.