학술논문
Venoarterial Extracorporeal Membrane Oxygenation With or Without Advanced Intervention for Massive Pulmonary Embolism.
Document Type
Article
Author
Source
Subject
*Pulmonary embolism
*Pearson correlation (Statistics)
*Statistical correlation
*Extracorporeal membrane oxygenation
*Thrombolytic therapy
*Academic medical centers
*Receiver operating characteristic curves
*Kruskal-Wallis Test
*Multiple regression analysis
*Logistic regression analysis
*Probability theory
*Questionnaires
*Discharge planning
*Treatment effectiveness
*Retrospective studies
*Chi-squared test
*Descriptive statistics
*Embolisms
*Vascular surgery
*Odds ratio
*Medical records
*Acquisition of data
*Life support systems in critical care
*Research
*Statistics
*Research methodology
*Confidence intervals
*Comparative studies
*Data analysis software
*Survival analysis (Biometry)
*Algorithms
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Language
ISSN
0267-6591
Abstract
Introduction: Massive pulmonary embolism (MPE) is a rare but highly fatal condition. Our study's objective was to evaluate the association between advanced interventions and survival among patients with MPE treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods: This is a retrospective review of the Extracorporeal Life Support Organization (ELSO) registry data. We included adult patients with MPE who were treated with VA-ECMO during 2010–2020. Our Primary outcome was survival to hospital discharge; secondary outcomes were ECMO duration among survivors and rates of ECMO-related complications. Clinical variables were compared using the Pearson chi-square and Kruskal-Wallis H tests. Results: We included 802 patients; 80 (10%) received SPE and 18 (2%) received CDT. Overall, 426 (53%) survived to discharge; survival was not significantly different among those treated with SPE or CDT on VA-ECMO (70%) versus VA-ECMO alone (52%) or SPE or CDT before VA-ECMO (52%). Multivariable regression found a trend towards increased survival among those treated with SPE or CDT while on ECMO (AOR 1.8, 95% CI 0.9–3.6), but no significant correlation. There was no association between advanced interventions and ECMO duration among survivors, or rates of ECMO-related complications. Conclusion: Our study found no difference in survival in patients with MPE who received advanced interventions prior to ECMO, and a slight non-significant benefit in those who received advanced interventions while on ECMO. [ABSTRACT FROM AUTHOR]