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]