Erschienen in:
29.09.2022 | Original Article
Clinical picture of the duration of venoarterial extracorporeal membrane oxygenation: analysis from JROAD-DPC
verfasst von:
Kazuo Sakamoto, Tetsuya Matoba, Michikazu Nakai, Yoshio Tahara, Takahiro Nakashima, Hayato Hosoda, Yoshihiro Miyamoto, Kunihiro Nishimura, Yoko Sumita, Tsukasa Yagi, Kenzo Ichimura, Naohiro Yonemoto, Eizo Tachibana, Ken Nagao, Takanori Ikeda, Naoki Sato, Hiroyuki Tsutsui
Erschienen in:
Heart and Vessels
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Ausgabe 2/2023
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Abstract
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used for critically ill patients all over the world; however, comprehensive survey regarding the relationship between VA-ECMO duration and prognosis is limited. We conducted a survey of VA-ECMO patients in the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC), which was a health insurance claim database study among cardiovascular centers associated with the Japan Circulation Society, between April 2012 and March 2016. Out of 13,542 VA-ECMO patients, we analyzed 5766 cardiovascular patients treated with VA-ECMO. 68% patients used VA-ECMO only for 1 day and 93% had VA-ECMO terminated within 1 week. In multivariate analysis, the hazard ratio of 1-day support was significantly high at 1.72 (95% confidence intervals; 95% CI 1.53–1.95) (p < 0.001), while that of 2-day [0.60 (95% CI 0.49–0.73)], 3-day [0.75 (95% CI 0.60–0.94)], 4-day [0.43 (95% CI 0.31–0.60)] and 5-day support [0.62 (95% CI 0.44–0.86)] was significantly low. Comprehensive database analysis of JROAD-DPC revealed that cardiovascular patients who were supported with VA-ECMO for 2–5 days showed lower mortality. The optimal VA-ECMO support window should be investigated in further studies.