Prevalence and Risk Factors for Weaning Failure From Venovenous Extracorporeal Membrane Oxygenation in Patients With Severe Acute Respiratory Insufficiency*
Authors' conclusion
Seventy-nine percent of patients were successfully decannulated with only 4% needing prolonged ECMO weaning. Before EWT only parameters of impaired ventilation (insufficient decarboxylation, higher respiratory rate) but not of oxygenation were predictive for weaning failure, whereas during EWT-impaired oxygenation was associated with weaning failure.
Study context
- Population
- Patients with severe acute respiratory insufficiency requiring VV-ECMO, medical ICU, University Hospital Regensburg, October 2011–December 2017
- Participants
- 227 patients
- Exposure
- Failed vs successful ECMO weaning trials
- Outcome
- Successful decannulation and prolonged weaning
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Successfully decannulated (179 of 227)
79%
Prolonged weaning (≥3 failed ECMO weaning trial (EWTs) before successful decannulation), 10 patients
4%
Observational data: associations, not effects.
Further findings
Risk factors for ECMO weaning failure: Pa co2 and respiratory rate (multivariable analysis)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Pa co2Multivariable analysis | 1.05 (1.001–1.10) | P = 0.045 | |
| Respiratory rateMultivariable analysis | 1.10 (1.04–1.15) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Respiratory rate and Pa co2 before EWTFailed EWT vs Successful EWT | Respiratory rate 19/min vs 16/min | P = 0.002 |
| Respiratory rate and Pa co2 before EWTFailed EWT vs Successful EWT | Pa co2 44 mm Hg vs 40 mm Hg | P = 0.003 |
| Rapid shallow breathing index before EWT | Rapid shallow breathing index 42 (1/L*min), vs 35 (1/L*min) | P = 0.052 |
Prolonged weaning (≥3 failed EWTs before successful decannulation)
- Prolonged weaning
- 10 (4%)
Decline of SaO2 and PaO2/FiO2 during EWT
- Decline higher in failed than successful trials
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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