Extracorporeal Membrane Oxygenation and Reperfusion Strategies in High-Risk Pulmonary Embolism Hospitalizations
Authors' conclusion
In patients with high-risk PE and refractory hemodynamic instability, ECMO may be a valuable supportive treatment in conjunction with reperfusion treatment but not as a stand-alone treatment especially for patients suffering from cardiac arrest.
Study context
- Population
- High-risk Pulmonary Embolism (PE) hospitalizations, US Nationwide Inpatient Sample 2016–2020Extracorporeal membrane oxygenation (ECMO) in 2,805 (2.3%)
- Participants
- 122,735 hospitalizations
- Exposure
- ECMO stand-alone or with thrombolysis-based or mechanical reperfusion vs neither reperfusion nor ECMO
- Outcome
- In-hospital mortality and major bleeding
Methodological detailsnationwide inpatient sample
- Nationwide inpatient sample
Main finding
As reported in the abstract
In-hospital mortality
Each group vs neither reperfusion nor ECMOAdjusted odds ratio (95% CI)
ECMO plus thrombolysis-based reperfusion
0.61(0.38–0.98)
ECMO plus mechanical reperfusion
1.03(0.67–1.60)
ECMO stand-alone
1.60(1.22–2.10)
Observational data: associations, not effects.
Further findings
In-hospital mortality, cardiac arrest subgroup (ECMO vs no ECMO)
| aOR (95% CI) | ||
|---|---|---|
| ECMO | 0.71 (0.53–0.93) | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | aOR (95% CI) | |
|---|---|---|
| In-hospital mortality among all patients on ECMO, reperfusion vs no reperfusionThrombolysis-based reperfusion vs No reperfusion · significant | 0.55 (0.33–0.91) | |
| In-hospital mortality among all patients on ECMO, reperfusion vs no reperfusionMechanical reperfusion vs No reperfusion · trend | 0.75 (0.47–1.19) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Safety
Major bleeding among patients on ECMO, reperfusion vs no reperfusion
- No increase in major bleeding with thrombolysis-based or mechanical reperfusion
Original publication
Extracorporeal Membrane Oxygenation and Reperfusion Strategies in High-Risk Pulmonary Embolism Hospitalizations. Crit Care Med. Published 21 June 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →