Factors associated with decreased compliance after on-site extracorporeal membrane oxygenation cannulation for acute respiratory distress syndrome: A retrospective, observational cohort study

Autor: Sylvain Le Pape, Florent Joly, François Arrivé, Jean-Pierre Frat, Maeva Rodriguez, Maïa Joos, Laura Marchasson, Mathilde Wairy, Arnaud W. Thille, Rémi Coudroy
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Intensive Medicine, Vol 4, Iss 2, Pp 194-201 (2024)
Druh dokumentu: article
ISSN: 2667-100X
DOI: 10.1016/j.jointm.2023.09.004
Popis: Background: Extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) is systematically associated with decreased respiratory system compliance (CRS). It remains unclear whether transportation to the referral ECMO center, changes in ventilatory mode or settings to achieve ultra-protective ventilation, or the natural evolution of ARDS drives this change in respiratory mechanics. Herein, we assessed the precise moment when CRS decreases after ECMO cannulation and identified factors associated with decreased CRS. Methods: To rule out the effect of transportation and the different modes of ventilation on CRS, we conducted a retrospective, single-center, observational cohort study from January 2013 to May 2020, on 22 patients with severe ARDS requiring on-site ECMO and ventilated in pressure-controlled mode to achieve ultra-protective ventilation. CRS was assessed at different time points ranging from 12 h before ECMO cannulation to 72 h after ECMO cannulation. The primary outcome was the relative change in CRS between 3 h before and 3 h after ECMO cannulation. The secondary outcomes included variables associated with the relative changes in CRS within the first 3 h after ECMO cannulation and the relative changes in CRS at each time point. Results: CRS decreased within the first 3 h after ECMO cannulation (−28.3%, 95% confidence interval [CI]: −38.8 to −17.9, P
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