Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure
Authors' conclusion
ECMO was associated with lower mortality and higher hospital costs, suggesting that it may be an important salvage therapy for refractory AERF following confirmatory clinical trials.
Study context
- Population
- Adults admitted to an extracorporeal membrane oxygenation (ECMO)-capable US hospital with asthma exacerbation with respiratory failure, treated with short-acting bronchodilators, systemic corticosteroids and invasive ventilation, ICU stay, 2010–2020
- Participants
- 13,714 adults
- Exposure
- ECMO vs No ECMO
- ECMOn = 127
- No ECMOn = 13,587reference
- Outcome
- Hospital mortality
Methodological detailsobservational, epidemiologic, national administrative data set, covariate-adjusted, propensity score-adjusted and propensity score-matched models
- Observational
- Epidemiologic
- National administrative data set
- Covariate-adjusted, propensity score-adjusted and propensity score-matched models
Main finding
As reported in the abstract
ECMO vs No ECMOOdds ratio (95% CI)P value
Covariate-adjusted
0.33(0.17–0.64)
P = 0.001Propensity score-adjusted
0.36(0.16–0.81)
P = 0.01Propensity score-matched
0.48(0.24–0.98)
P = 0.04Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| Total hospital costsIncreased in all three models | P < 0.0001 |
Hospital mortality (sensitivity analyses)
- Mortality reduction with ECMO, OR range
- 0.34 to 0.61
ICU length of stay (LOS), hospital LOS, time on invasive ventilation
- ECMO not associated with decrease vs No ECMO
Original publication
Extracorporeal Membrane Oxygenation for Refractory Asthma Exacerbations With Respiratory Failure. Chest. Published 30 September 2022. doi:10.
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