Early Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Acute Brain Injury and Mortality in Patients With Cardiogenic Shock
Authors' conclusion
Hyperoxia (Pa o2 ≥150 mm Hg) at both 4 and 24 hours post-ECMO initiation was significantly associated with ABI, while severe hyperoxia (Pa o2 ≥300 mm Hg) at 24 hours correlated with in-hospital mortality.
Study context
- Population
- Patients with cardiogenic shock on venoarterial extracorporeal membrane oxygenation (VA-ECMO), Beijing Anzhen Hospital, January 2017–January 2024
- Participants
- 481 patients
- Exposure
- Mild, moderate and severe hyperoxia vs normoxia during VA-ECMO
- Outcome
- Acute brain injury (ABI: IS + ICH, HIBI, NEA)
Methodological detailssingle-centre, multivariable logistic regression
- Single-centre
- Multivariable logistic regression
Main finding
As reported in the abstract
Composite ABI · 4 hours post-ECMO
Each group vs normoxiaOdds ratio (95% CI)
Mild hyperoxia
2.33(1.10–4.96)
Moderate hyperoxia
4.16(2.16–8.02)
Severe hyperoxia
6.10(3.33–11.2)
- Acute brain injury (ABI) overall
- 164 (34.1%)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Composite ABI · 24 hoursMild hyperoxia vs Normoxia | 3.44 (1.88–6.29) | |
| Composite ABI · 24 hoursModerate hyperoxia vs Normoxia | 3.28 (1.80–5.97) | |
| Composite ABI · 24 hoursSevere hyperoxia vs Normoxia | 4.78 (2.14–11.2) | |
| In-hospital mortalitySevere hyperoxia vs Normoxia · independent predictor | 2.46 (1.25–4.84) | |
| 0.050.21520Odds ratio (log scale) |
ABI subtypes
- Ischemic stroke (IS) + intracranial hemorrhage (ICH)
- n = 73, 44.5%
- Hypoxic-ischemic brain injury (HIBI)
- n = 25, 5.20%
- Neurological examination abnormalities (NEA)
- n = 66, 13.7%
Original publication
Early Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Acute Brain Injury and Mortality in Patients With Cardiogenic Shock. Anesth Analg. Published 16 October 2025. doi:10.
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