Tidal volume and mortality during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a multicenter observational cohort study
Authors' conclusion
Mortality predictors change during the course of an ECMO run. In a cohort with high mortality, on day 14 of ECMO support for ARDS, tidal volume may be an independent predictor of mortality.
Study context
- Population
- Patients with COVID-19 acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) in 29 German centres, January 2020–July 2021
- Participants
- 1,137 patients · 29 German centres
- Exposure
- Day-by-day predictors of mortality during the first 14 days of ECMO
- Outcome
- All-cause ICU mortality
Methodological detailsmultivariable stepwise logistic regression, retrospectively registered
- Multivariable stepwise logistic regression
- Retrospectively registered
Main finding
As reported in the abstract
ICU mortality in the cohort
75%
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Tidal volume on ECMO day 14 (per 1 mL/kg predicted body weight increase) and mortalityIndependently associated with mortality | 0.693 (0.564–0.851) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
- Tidal volume on ECMO day 14 (per 1 mL/kg predicted body weight increase) and mortality — Adjusted mortality with tidal volume below 2 mL/kg on day 14 above
- 80% (lower limit of the 95% CI)
Predictors on ECMO day 1
- Only age and lactate remained in the final mortality prediction model
Mortality of patients still ECMO-dependent on day 14
- Comparable to all patients receiving ECMO on day 1
Original publication
Tidal volume and mortality during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a multicenter observational cohort study. Ann Intensive Care. Published 6 October 2025. doi:10.
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