Predictors for Successful Weaning from Veno-Venous Extracorporeal Membrane Oxygenation in Patients with Severe Acute Respiratory Distress Syndrome.

Abstract

Purpose: This study aimed to investigate the predictors of successful weaning from veno-venous extracorporeal membrane oxygenation (VV-ECMO) among patients with severe acute respiratory distress syndrome (ARDS) in our centre.

Methods: The clinical data of patients with severe ARDS who were treated with VV-ECMO between January 2019 and January 2022 were retrospectively analysed. Due to the outcomes of weaning from extracorporeal membrane oxygenation (ECMO), the considered patients with ARDS were divided into a successful weaning group and an unsuccessful weaning group. Logistic regression analysis was employed to evaluate predictors for successful VV-ECMO weaning among patients with severe ARDS.

Results: A total of 65 patients with severe ARDS were included for analysis. Among them, 31 (47.69%) patients were grouped into the successful weaning group, while 34 (52.30%) patients were grouped into the unsuccessful weaning group. Univariate analysis showed that Age (odds ratio [OR] =0.939; 95% confidence interval [CI] =0.896-0.983; p = 0.008), APACHEII scores before ECMO (OR =0.651; 95% CI =0.537-0.789; p < 0.001), Renal insufficiency (OR =0.061; 95% CI =0.012 -0.298; p = 0.001), MAP before ECMO (OR =1.246; 95% CI =1.114-1.392; p<0.001), PaO2 during ECMO (OR =1.083; 95% CI =1.033-1.135; p = 0.001), and CRRT (OR =0.080; 95% CI =0.022-0.285; p = 0.008) were identified as an independent predictor of successful VV-ECMO weaning. After multivariate analysis was performed, APACHE II scores before ECMO (OR = 0.651; 95% CI = 0.462-0.919; p = 0.015) were identified as independent predictors for successful VV-ECMO weaning.

Conclusion: In conclusion, in severe ARDS patients, lower APACHE II scores predicted successful wean from VV-ECMO.