Extracorporeal Membrane Oxygenation (ECMO): What We Need to Know

Rabah, Hussein; Rabah, Ali A.

doi:10.7759/cureus.26735

Cited by 6 publications

(3 citation statements)

References 37 publications

(42 reference statements)

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“…The removal of CO2 is impeded by these altered mechanics, potentially resulting in hypercapnia. While ECMO provides extracorporeal support for both oxygenation and CO2 removal, its efficacy is influenced by various external factors, including pump speed, blood flow rate, and the efficiency of the oxygenator and sweep gas [ 34 ]. It is essential to recognize that the effectiveness of ECMO is not solely determined by the inherent nature of the lung disease; rather, it is a complex interplay of external parameters.…”

Section: Discussionmentioning

confidence: 99%

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Huang,

Lin

2024

BMC Pulm Med

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Background Extracorporeal membrane oxygenation (ECMO) is used when standard methods of standard treatment methods are not successful. Obese patients present unique challenges during ECMO due to large body size hindering sufficient flows, difficulties with patient positioning and anatomical landmark identification, and restricted radiology scans. This meta-analysis aims to investigate the impact of obesity on the outcomes of patients undergoing ECMO. Methods Databases (PubMed, Embase, and Scopus databases) were searched to identify relevant studies published until July 2023. Data were reported as odds ratios (OR) with 95% confidence interval (CI), and the descriptive data were reported as standard difference of means (SDM) by a random effects model. Results A literature search identified 345 studies. Of them, 18 studies met the inclusion criteria. The findings from the meta-analysis revealed no significant association between obesity and survival outcomes after ECMO (odds ratio (OR): 0.91, 95% confidence interval (CI): 0.70–1.17, p: 0.46). Moreover, no comparative significant differences were found between obese and non-obese individuals on the duration of ECMO procedure (standardized mean difference (SMD): 0.07, -0.03–0.17), length of hospital stay (-0.03, -0.19 to 0.12), and duration of ventilation support (-0.10, -0.44 to 0.24). Conclusion The meta-analysis findings suggest no significant impact of obesity on the survival outcomes after the ECMO procedure. There was no significant impact of obesity on the duration of ECMO procedures, length of hospital stay, and duration of ventilation support.

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Section: Discussionmentioning

confidence: 99%

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Huang,

Lin

2024

BMC Pulm Med

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“…The COVID-19 pandemic, with its unprecedented global impact, has exerted immense pressure on healthcare systems worldwide, challenging their capacity to respond to severe respiratory and cardiac complications [ 1 - 3 ]. Among the arsenal of interventions employed to address the clinical complexities associated with this novel virus, extracorporeal membrane oxygenation (ECMO) has emerged as a vital life support modality [ 4 ]. While ECMO has long been recognized as an advanced therapy for critical cardiopulmonary failure, its utilization patterns, patient population, and resource implications have experienced a seismic shift in response to the pandemic's unique demands.…”

Section: Introductionmentioning

confidence: 99%

Rates, Outcomes, and Resource Burden of Extracorporeal Membrane Oxygenation Use in Hospitalizations in the United States During the Pandemic

Uwumiro,

Otabor,

Okpujie

et al. 2024

Cureus

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Introduction: Extracorporeal membrane oxygenation (ECMO) is a lifesaving medical intervention for patients with severe refractory cardiopulmonary dysfunction. This study aims to characterize hospitalizations and resource use burdens associated with ECMO use during the onset of the pandemic. Methods: We performed a retrospective analysis of ECMO use in United States (US) hospitals between 2019 and 2020, utilizing data from the National Inpatient Sample database. Patient demographics, comorbidities, admission characteristics, inpatient mortality, length of hospital stay (LOS), healthcare costs, and ECMO utilization trends were assessed. Results: Of the 17,520 hospitalizations analyzed, the most common reasons for admission were diseases and disorders of the circulatory system (40.5%) and diseases and disorders of the respiratory system (31.2%). The average patient age was 52.5 years, with a male predominance (64.2%). Hospitalizations were predominantly for White Americans (59.5%), followed by Blacks (16.3%) and Hispanics (14.8%). Nearly 88.2% of cases were at an extremely high risk of mortality without intervention. Inpatient mortality was significantly associated with Hispanic descent, a higher Charlson Comorbidity Index (CCI) score, age >60 years, and a higher All Patients Refined Diagnosis Related Groups (APRDRG) risk of mortality. Hospitalizations involving ECMO had a significantly higher inpatient mortality rate compared to non-ECMO hospitalizations (43.1% vs. 2.1%, p<0.0001). The mean LOS was 26 days for ECMO hospitalizations, with ECMO initiation occurring approximately five days from admission. ECMO-related hospitalizations often involve over 10 unique procedures, resulting in an average healthcare cost of US$967,647 per hospitalization, totaling US$16.7 billion. Comparatively, non-ECMO hospitalizations had shorter LOS and lower mean costs (mean LOS, 4.7 days, and US$52,659, respectively). ECMO utilization increased significantly from 2019 to 2020, reflecting rising demand for this life-saving therapy. Conclusion: Compared to non-ECMO hospitalizations, ECMO patients had higher inpatient mortality, associated with Hispanic descent, higher CCI scores, an age >60 years, and a higher APRDRG risk. ECMO hospitalizations had longer stays (26 days) and higher costs (US$967,647 per case, US$16.7 billion total) compared to pre-pandemic levels. ECMO use increased significantly from 2019 to 2020, reflecting rising demand.

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“…The overarching goal of ECMO is to provide temporary support to failing organs, thereby allowing the patient's native organs to rest and recover. This intervention is particularly vital in situations where conventional therapies fall short, such as in cases of severe acute respiratory distress syndrome (ARDS) or refractory cardiac failure [3]. The roots of ECMO trace back to the 1950s, marked by pioneering efforts in extracorporeal circulation and oxygenation.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Review of Extra Corporeal Membrane Oxygenation: The Lifeline in Critical Moments

Geetha,

Verma,

Chakole

2024

Cureus

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Extracorporeal membrane oxygenation (ECMO) has evolved into a pivotal intervention in critical care, offering a lifeline for patients facing severe respiratory or cardiac failure. This review provides a comprehensive exploration of ECMO, spanning its definition and historical background to its contemporary advancements and ongoing impact in critical care. The versatility of ECMO in addressing diverse critical conditions, careful patient selection criteria, and the nuanced management of complications are discussed. Advances in technology, including miniaturization, novel circuit designs, and the integration of remote monitoring, showcase the evolving landscape of ECMO. The review underscores the ongoing impact of ECMO in improving survival rates, enhancing mobility, and enabling remote expertise. As a symbol of hope and innovation, ECMO's lifesaving potential is evident in its ability to navigate the complexities of critical care and redefine the boundaries of life support interventions.

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Extracorporeal Membrane Oxygenation (ECMO): What We Need to Know

Cited by 6 publications

References 37 publications

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Impact of obesity on outcomes of extracorporeal membrane oxygenation support: a systematic review and meta-analysis

Rates, Outcomes, and Resource Burden of Extracorporeal Membrane Oxygenation Use in Hospitalizations in the United States During the Pandemic

A Comprehensive Review of Extra Corporeal Membrane Oxygenation: The Lifeline in Critical Moments

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