Choosing a Pump for Extracorporeal Membrane Oxygenation in the USA

Background: The aim of this study was to determine epidemiology and outcomes of acute kidney injury (AKI) in patients on extracorporeal membrane oxygenation (ECMO) and to assess if age modifies the effect of AKI on mortality. Methods: Using National (Nationwide) Inpatient Sample Database for hospitalizations in the USA from 2003 to 2014, we identified adult patients on ECMO support. Using International Classification of Diseases 9th Revision, we assessed the rates of AKI and AKI requiring dialysis (AKI-D) among them and associated survival. We used a multivariable logistic regression to identify risk factors of and differential effect of age on mortality from AKI. Results: AKI was seen in 63.9% of 17,942 ECMO hospitalizations: 21.9% of those with AKI required dialysis. The percentage of those with AKI increased steadily. Mortality was higher in those with AKI, with highest in those with AKI-D (70.8% vs. 61.7%; p < 0.001). While both age and AKI were independent predictors of mortality, age was neither a risk factor for AKI nor did it modify the effect of AKI on mortality. Conclusions: AKI is common and is increasing among patients on ECMO support. Patients on ECMO have high mortality and AKI is an independent predictor of mortality. Though age is also an independent predictor of mortality in patients on ECMO, it is neither a predictor of AKI nor does not modify the relationship between AKI and mortality.

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National estimates of the use and outcomes of extracorporeal membrane oxygenation after acute trauma

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2018-000209 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000209 ◽

Cited By ~ 1

Author(s):

Parker J Hu ◽

Lauren Griswold ◽

Lauren Raff ◽

Rachel Rodriguez ◽

Gerald McGwin Jr ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Statistical Significance ◽

Trauma Patients ◽

Level Of Evidence ◽

Traumatic Injuries ◽

Membrane Oxygenation ◽

Diagnostic Codes ◽

The Usa ◽

Ninth Edition ◽

National Estimates

BackgroundThe use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for patients with severe acute respiratory distress syndrome is gaining greater acceptance among trauma intensivists. The objective of this study was to review ECMO usage in trauma patients in the USA.MethodsThe National Inpatient Sample (NIS) from years 2002 to 2012 was queried for patients aged 15 and older treated with ECMO who had one or more acute traumatic injuries as defined by the International Diagnostic Codes, Ninth Edition (ICD-9). The primary outcomes of interest were incidence of ECMO and overall inpatient mortality.ResultsA total of 1347 patients were identified in the NIS database who had both ECMO performed and ICD-9 codes consistent with trauma. Patients were predominantly aged 15 to 29 years (31.4%) and were male (65.5%). The incidence of ECMO for patients after traumatic injuries has increased 66-fold during the 10-year period. In-hospital mortality was 48.0% overall, with a decreasing trend during the study period that approached statistical significance (p=0.06).DiscussionAlthough ECMO use in patients in the post-trauma setting remains controversial, there is an increasing trend to use ECMO nationwide, suggesting an increasing acceptance and/or increased availability at trauma centers. Given the decrease in mortality during the study period, ECMO as a salvage method in trauma patients remains a potentially viable option. Evaluation in a prospective manner may clarify risks and benefits.Level of evidenceLevel IV, epidemiological.

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Research Trends and Hotspots of Extracorporeal Membrane Oxygenation: A 10-Year Bibliometric Study and Visualization Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.752956 ◽

2021 ◽

Vol 8 ◽

Author(s):

Huaqin Wang ◽

Siqi Deng ◽

Xiaoyu Fan ◽

Jinxiu Li ◽

Li Tang ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Visual Analysis ◽

Research Direction ◽

Developed Countries ◽

Membrane Oxygenation ◽

Management Of Complications ◽

Institutional Cooperation ◽

The Usa ◽

Number Of Publications ◽

Specialized Team

Objective: To determine the research hotspots and trends in the field of extracorporeal membrane oxygenation (ECMO), and to provide a reference for further and wider research in the future.Methods: The literatures on ECMO from January 2011 to July 2021 in the Web of Science Core Collection (WOSCC) database were searched, and Citespace5.8.R1 software was used to conduct bibliographic and visual analysis on the literature by country, institution, author and keywords.Results: A total of 5,986 articles were enrolled. According to an observation, the number of articles published in the past decade has increased, especially from 2019 to 2020. The USA had the largest number of publications, while less ECMO related studies were conducted among non-developed countries. The University of Michigan (Univ Michigan) was the institution that had the largest number of publications and the highest centrality, and Daniel B was the author who had the largest number of publications. However, more inter-institutional cooperation among author teams was needed. The focus of existing ECMO research has primarily been on the treatment of patients suffering from severe cardiopulmonary failure, and the prevention and management of complications during the application ECMO.Conclusion: Inter-regional and inter-institutional cooperation and exchanges should be carried out among ECMO research teams and institutions. The suggested research direction is to further broaden the application scope of ECMO, while determining the ways to reduce the incidence of complications and the cost, cultivate specialized team talents, and promote the application thereof.

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