Upper gastrointestinal bleeding on veno-arterial extracorporeal membrane oxygenation support
Authors' conclusion
UGIB occurred in at least 1 out of 10 cases of V-A ECMO patients, with significant consequences on healthcare resources. Enteral nutrition and proton pump inhibitor prophylaxis did not appear to protect V-A ECMO patients.
Study context
- Population
- V-A ECMO patients (after cardiac surgery or medical etiology), excluding those who died within 24 h, 2013–201765 after cardiac surgery, 85 medical
- Participants
- 150 patients
- Exposure
- Upper gastrointestinal bleeding (UGIB) vs no UGIB
- UGIBn = 16
- Outcome
- Incidence of UGIB
- Follow-up
- From ECMO initiation until 5 days after explantation
Methodological detailssingle-centre, 90% received prophylactic proton pump inhibitor therapy and enteral nutrition
- Single-centre
- 90% received prophylactic proton pump inhibitor therapy and enteral nutrition
Main finding
As reported in the abstract
UGIB
10.7%
16
- Median occurrence of UGIB
- 10 [7-17] days
Observational data: associations, not effects.
Further findings
Independent risk factor of UGIB: history of peptic ulcer
| OR (95% CI) | P value | ||
|---|---|---|---|
| History of peptic ulcerOnly independent risk factor | 7.32 (1.07–50.01) | P = 0.042 | |
| 0.050.21520Odds ratio (log scale) |
Resource use (RBC and FFP needs, mechanical ventilation and V-A ECMO duration, ICU and hospital LOS)
- Significantly increased in UGIB
Mortality
- No significant difference
Clinical or biological characteristics on day of esophagogastroduodenoscopy (EGD)
- No significant differences
Original publication
Upper gastrointestinal bleeding on veno-arterial extracorporeal membrane oxygenation support. Ann Intensive Care. Published 3 July 2024. doi:10.
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