Respiratory failure & ventilation
Physiological and clinical effects of two ultraprotective ventilation strategies in patients with veno-venous extracorporeal membrane oxygenation: the ECMOVENT study
Main finding · Time to successful VV-ECMO weaningResult — go to the resultAdjusted subdistribution hazard ratio 0.99 95% CI 0.53–1.84Authors' conclusion
In the context of our center, a ventilatory strategy targeting a PEEP of 14 cmH2O, a ∆P of 8 cmH2O and a RR of 10 min-1 led to the application of ∆P, RR and static elastic mechanical power and improved decarboxylation, compared to a strategy in volumetric mode with a VT of 1 ml.kg-1 PBW and a RR of 5 min-1, in patients with ARDS and VV-ECMO. No significant difference on clinical outcomes was observed between both strategies.
Study context
- Population
- Consecutive patients treated with veno-venous extracorporeal membrane oxygenation (VV-ECMO) for severe acute respiratory distress syndrome (ARDS), 2016–2023
- Participants
- 121 patients
- Exposure
- ΔP8 strategy vs VT1 strategy
- VT1n = 69reference
- ∆P8n = 52
- Outcome
- Time to successful ECMO weaning
- Follow-up
- Day 90 after VV-ECMO cannulation
Methodological detailssingle-centre, before-and-after design
- Single-centre
- Before-and-after design
Main finding
Time to successful VV-ECMO weaning · day 90
Adjusted subdistribution hazard ratio
0.99
95% CI 0.53–1.84
P > 0.9
As reported in the abstract
Observational data: associations, not effects.
Further findings
Day-90 survival
P = 0.19
Respiratory mechanics over first 7 days of ECMO
- ∆P8 associated with significantly higher ∆P and RR, lower PaCO2 and higher static elastic mechanical power vs VT1
Original publication
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