Objectives:To explore the efficiency and potential prognostic factors of VV-ECMO for severe ARDS in adults by analyzing our institutional results and experience.Methods:All patients with severe ARDS supported by VV-ECMO and admitted to our hospital from Jul 2018 and Dec 2023.Patients were identified on the basis of the Berlin defi-nition of severe ARDS were analyzed retrospectively.The baseline data,clinical parameters were collected retrospectively.The patients were divided into two groups according to in-hospital mortality.Successful weaning was defined as weaning from ECMO support followed by survival for more than 48 h.Univariate analysis and Logistic regression identified risk factors for death in hospital.Results:56 VV-ECMO patients were included in this study.The mean age was(45±12)years,pneumonia was the main cause.Finally,28 patients were successfully weaned off VV-ECMO,but only 25 patients were discharged.As the result showed,VV-ECMO was effective in improving oxygenation and promoting carbon dioxide removal in patients with severe ARDS in the first 48 hours(P<0.05).Percutaneous catheterization was the preferred means of VV-ECMO(78.6%).And bleeding from site of catheterization or surgery(55.4%)was the most common compli-cation during ECMO,followed by infection 46.4%),hyperbilirubinemia(41.1%),acute renal failure(35.7%)and MODS(35.7%).In univariate analysis,there was statistical difference in ventilation tidal volume before ECMO,time interval from PaO2/FiO2<100 mmHg at FiO2>0.9 to ECMO,the peak value of TB and Cr and MODS during ECMO between the two groups(P<0.05).In addition,logistic regression identified that higher ventilation tidal volume before ECMO(OR=2.457,95%CI:1.037-5.821),the longer time interval from PaO2/FiO2<100 mmHg at FiO2>0.9 to ECMO(OR=1.464,95%CI:1.140-1.880)and MODS during ECMO(OR=23.732,95%CI:2.720-207.072)increase risk of death in hospi-tal.Conclusion:VV-ECMO is effective in improving oxygenation and promoting carbon dioxide removal in patients with severe ARDS.The higher ventilation tidal volume before ECMO,the longer time interval from PaO2/FiO2<100 mmHg at FiO2>0.9 to ECMO and MODS duration ECMO are independent risk factors for death in hospital.
维普
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