The Ventilatory Ratio as a Predictor of Successful Weaning from a Veno-Venous Extracorporeal Membrane Oxygenator
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. VR and PFR of Patients with Severe ARDS with Safe or Unsafe Liberation
3.3. Predictors of Unsafe Liberation from VV-ECMO
3.4. Secondary Outcome
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Appendix A.1. Standard Operating Procedure for Weaning from VV-ECMO
Appendix A.1.1. University Hospital Aachen
Appendix A.1.2. Massachusetts General Hospital
References
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All Patients | Safe Liberation | Unsafe Liberation | p-Value | |
---|---|---|---|---|
Characteristic | n = 84 | n = 70 | n = 14 | |
Age, y | 51 (39–60) | 51 (36–60) | 51 (45–53) | 0.89 |
Male sex | 50 (60%) | 39 (56%) | 11 (79%) | 0.14 |
BMI, kg/m2 | 51.1 (29.3–78.9) | 58.8 (29.6–79.0) | 31.5 (26.8–68.9) | 0.31 |
Reason for ECMO | ||||
ARDS due to COVID-19 pneumonia | 30 (36%) | 23 (33%) | 7 (50%) | 0.36 |
ARDS due to another cause of pneumonia | 25 (30.5%) | 22 (31%) | 3 (21.5%) | 0.54 |
ARDS post lung transplant | 8 (9.5%) | 8 (11%) | 0 (0%) | 0.34 |
Postoperative respiratory failure | 5 (6%) | 4 (6%) | 1 (7%) | 0.85 |
Other 1 | 16 (19%) | 13 (19%) | 3 (21.5%) | 0.81 |
VV-ECMO duration, d | 11 (5–20) | 10 (4–19) | 16 (13–19) | 0.04 * |
All Patients | Safe Liberation | Unsafe Liberation | p-Value | |
Characteristic | n = 40 | n = 31 | n = 9 | |
SOFA score during SGOT 3 | 6 (3–7) | 5 (3–7) | 7 (6–9) | 0.18 |
All Patients n = 84 | Safe Liberation n = 70 | Unsafe Liberation n = 14 | p-Value | |
---|---|---|---|---|
Characteristic | ||||
VR | 1.65 (1.39–2.81) | 1.58 (1.32–1.91) | 1.89 (1.79–2.81) | <0.01 * |
PFR | 241 (164–276) | 243 (185–287) | 169 (110–212) | 0.01 * |
OR (95%) CI | p-Value | |
---|---|---|
Characteristic | ||
VR | 0.38 (0.17–0.81) | 0.01 * |
PFR | 1.00 (0.99–1.01) | 0.35 |
Duration on VV-ECMO | 1.00 (0.98–1.02) | 0.83 |
All Patients n = 84 | Safe Liberation n = 70 | Unsafe Liberation n = 14 | p-Value | |
---|---|---|---|---|
Characteristic | ||||
Hospital LOS, days | 41 (28–62) | 38 (27–59) | 61 (38–79) | 0.04 * |
ICU LOS, days | 31 (17–51) | 26 (16–45) | 58 (30–78) | <0.01 * |
Mortality, % | 14 (17) | 9 (13) | 5 (38) | 0.051 |
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Fischbach, A.; Wiegand, S.B.; Simons, J.A.; Ammon, L.; Kopp, R.; Soccoro Matos, G.I.; Baigorri, J.J.; Crowley, J.C.; Bagchi, A. The Ventilatory Ratio as a Predictor of Successful Weaning from a Veno-Venous Extracorporeal Membrane Oxygenator. J. Clin. Med. 2024, 13, 3758. https://doi.org/10.3390/jcm13133758
Fischbach A, Wiegand SB, Simons JA, Ammon L, Kopp R, Soccoro Matos GI, Baigorri JJ, Crowley JC, Bagchi A. The Ventilatory Ratio as a Predictor of Successful Weaning from a Veno-Venous Extracorporeal Membrane Oxygenator. Journal of Clinical Medicine. 2024; 13(13):3758. https://doi.org/10.3390/jcm13133758
Chicago/Turabian StyleFischbach, Anna, Steffen B. Wiegand, Julia Alexandra Simons, Liselotte Ammon, Rüdger Kopp, Guillermo Ignacio Soccoro Matos, Julio Javier Baigorri, Jerome C. Crowley, and Aranya Bagchi. 2024. "The Ventilatory Ratio as a Predictor of Successful Weaning from a Veno-Venous Extracorporeal Membrane Oxygenator" Journal of Clinical Medicine 13, no. 13: 3758. https://doi.org/10.3390/jcm13133758