Vasopressor Requirements after Initiation of Venovenous Extracorporeal Membrane Oxygenation in Patients with Severe Respiratory Failure
Authors' conclusion
After initiation of V-V ECMO, a significant decrease in vasopressor requirements was observed, this benefit being directly attributable to the correction of severe respiratory acidosis.
Study context
- Population
- Adult V–V ECMO recipients (2010–2024) with severe respiratory failure requiring noradrenaline within 24 h before cannulation
- Participants
- 107 consecutive adults
- Exposure
- Vasopressor requirements before vs after V-V ECMO initiation
- Outcome
- Change in Vasoactive-Inotropic Score (VIS)
- Follow-up
- Day 0 (24 h before) to Day 1 (24 h after ECMO initiation)
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Daily mean VIS
Day 0
14
median · IQR 6–30
Day 1
12
median · IQR 5–22
Observational data: associations, not effects.
Secondary outcomes
Paw, PaCO2 and arterial pH · Day 0 to Day 1
- Significant reductions in Paw and PaCO2, significant increase in arterial pH
- P < 0.001 for all
Arterial pH and Vasoactive-Inotropic Score (VIS) (multivariate linear mixed-effects model)
- Higher arterial pH associated with lower VIS (β per +0.1-unit)
- −9.2, p < 0.001
Lactate and VIS (multivariate model)
- Higher lactate associated with higher VIS (β)
- 4.5, p < 0.001
Sensitivity analyses (high noradrenaline requirements subgroup)
- More pronounced effect of pH increase on VIS reduction in patients with high noradrenaline requirements
Original publication
Vasopressor Requirements after Initiation of Venovenous Extracorporeal Membrane Oxygenation in Patients with Severe Respiratory Failure. Ann Intensive Care. Published 16 January 2026. doi:10.
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