Hyperoxia and End-Organ Complications Among Cardiogenic Shock Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation
Authors' conclusion
Severe hyperoxia in patients with CS receiving VA-ECMO is associated with increased mortality and more end-organ complications. However, most of the effect of severe hyperoxia on mortality occurs via direct effects, independent of end-organ complications.
Study context
- Population
- Adults with cardiogenic shock supported on venoarterial extracorporeal membrane oxygenation (VA-ECMO), Extracorporeal Life Support Organization Registry, 2010–2023
- Participants
- 10,541 adults
- Exposure
- Mild or severe hyperoxia vs normoxia
- Outcome
- In-hospital mortality
Methodological detailsmulticenter, multinational, registry, causal mediation analysis
- Multicenter
- Multinational
- Registry
- Causal mediation analysis
Main finding
As reported in the abstract
Each group vs normoxiaAdjusted odds ratio (95% CI)
Severe hyperoxia
2.17(1.19–2.50)
Mild hyperoxia
1.34(1.19–1.50)
Observational data: associations, not effects.
Further findings
End-organ complications and mortality
| aOR (95% CI) | ||
|---|---|---|
| End-organ complicationsIncrementally predicted higher mortality | 1.42 (1.25–1.61) | |
| 0.512Adjusted odds ratio (log scale) |
- Severe hyperoxia associated with more end-organ complications
Mediation analysis of hyperoxia effect on mortality
- Direct effect
- 86%
- Neurologic complications
- 3.1%
- Hepatic complications
- 3.9%
- Renal complications
- 3.5%
- Bleeding complications
- 2.3%
Original publication
Hyperoxia and End-Organ Complications Among Cardiogenic Shock Patients Supported by Venoarterial Extracorporeal Membrane Oxygenation. Crit Care Med. Published 6 August 2025. doi:10.
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