Outcomes With Single-Site Dual-Lumen Versus Multisite Cannulation for Adults With COVID-19 Respiratory Failure Receiving Venovenous Extracorporeal Membrane Oxygenation*
Authors' conclusion
In this retrospective study of COVID-19 patients requiring VV-ECMO, 90-day survival did not differ between patients treated with a multisite versus SSDL cannulation strategy and there were only modest differences in major complication rates.
Study context
- Population
- Adults with COVID-19 respiratory failure receiving VV-ECMO, Extracorporeal Life Support Organization Registry, 170 centresmatched cohort
- Participants
- 2,628 adults
- Exposure
- Multisite vs single-site dual-lumen cannulation
- Multisiten = 1,752
- Single-site dual-lumen (SSDL)n = 876reference
- Outcome
- 90-day survival
- Follow-up
- 90 days
Methodological detailspropensity score matched (2:1), multicentre registry
- Propensity score matched (2:1)
- Multicentre registry
Main finding
As reported in the abstract
Multisite
49.4
%
SSDL
48.9%
P = 0.66
Observational data: associations, not effects.
Secondary outcomes
Survival to hospital discharge · no difference
P = 0.44
Extubated within 24 hours · more in SSDL
P = 0.001
Duration of ECMO support · no difference
P = 0.82
Hospital LOS after cannulation · no difference
P = 0.37
ECMO-free days · 90 days · more in multisite
P = 0.02
ECMO flows · 24 hours · higher in multisite
P < 0.001
Safety
Pneumothorax · higher in SSDL
P = 0.03
Cannula site bleeding · more frequent in multisite
P = 0.03
Oxygenator failure · more frequent in multisite
P = 0.03
Circuit clots · more frequent in multisite
P = 0.02
Original publication
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