Conversion From Venovenous to Venoarterial or Hybrid Extracorporeal Membrane Oxygenation: Analysis From the Extracorporeal Life Support Organization Registry
Authors' conclusion
The venovenous patients converted to other ECMO configurations were 2.4% and experienced higher complication and mortality rates.
Study context
- Population
- Adults (≥ 18 yr) with VV extracorporeal membrane oxygenation (ECMO) as initial cannulation strategy, ELSO Registry 2010–2020
- Participants
- 28,888 eligible VV ECMO runs
- Exposure
- Conversion from VV to VA or hybrid ECMO vs remaining on VV ECMO
- Convertedn = 702
- Venoarterialn = 399
- Hybridn = 303
- Outcome
- Configuration conversion
Methodological detailsmulticentre, multivariable analysis
- Multicentre
- Multivariable analysis
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Time to conversion after ECMO initiation
- Median time to conversion (IQR 11.5-210 hr)
- 56 hours
- Earlier conversion to hybrid configuration
Variables associated with conversion (multivariable analysis)
- Pre-ECMO cardiac conditions, bridge to lung transplant as indication, use of milrinone, epinephrine, sildenafil, bicarbonate, and 24-hour Pa o2 value
Safety
- Increased rates of cardiovascular, hemorrhagic, vascular, renal, metabolic, infective and circuit-related complications in converted patients
Original publication
Conversion From Venovenous to Venoarterial or Hybrid Extracorporeal Membrane Oxygenation: Analysis From the Extracorporeal Life Support Organization Registry. Crit Care Med. Published 16 January 2026. doi:10.
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