Extracorporeal membrane oxygenation for the treatment of massive pulmonary embolism. An analysis of the Extracorporeal Life Support Organization (ELSO) database
Authors' conclusion
ECMO use for massive PE is increasing globally, and overall mortality rates compare favorably with other indications of ECMO. The use of ECPR and worsening metabolic status at initiation were associated with higher in-hospital mortality
Study context
- Population
- Patients with massive pulmonary embolus (PE) treated with extracorporeal membrane oxygenation (ECMO), international ELSO registry
- Participants
- 821 patients · 833 ECMO episodes
- Exposure
- Extracorporeal cardiopulmonary resuscitation (ECPR) vs venoarterial (VA) ECMO vs VV ECMO
- VA ECMOn = 489
- ECPRn = 229
- VV ECMOn = 85
- Outcome
- In-hospital mortality
Methodological detailsregistry (ELSO database), international
- Registry (ELSO database)
- International
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Independent predictors of in-hospital mortality (multivariable)
| OR (CI) | ||
|---|---|---|
| ECPRECPR mode | 3.67 (1.46–9.230) | |
| 0.10.31310Odds ratio (log scale) |
- Independent predictors of in-hospital mortality (multivariable) — Increasing age, OR
- 1.02 (1.00-1.03) (CI)
- Independent predictors of in-hospital mortality (multivariable) — Lower pH, OR
- 0.18 (0.03-0.44) (CI)
- Independent predictors of in-hospital mortality (multivariable) — Lower DBP, OR
- 0.99 (0.97-1.00) (CI)
ECMO episodes per year
- Increased over study period, predominantly driven by ECPR
Original publication
Extracorporeal membrane oxygenation for the treatment of massive pulmonary embolism. An analysis of the ELSO database. Resuscitation. Published 23 August 2023. doi:10.
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