PMID- 37246150
OWN - NLM
STAT- MEDLINE
DCOM- 20240510
LR  - 20240510
IS  - 1477-111X (Electronic)
IS  - 0267-6591 (Linking)
VI  - 39
IP  - 4
DP  - 2024 May
TI  - Venoarterial Extracorporeal Membrane Oxygenation With or Without Advanced 
      Intervention for Massive Pulmonary Embolism.
PG  - 665-674
LID - 10.1177/02676591231177909 [doi]
AB  - INTRODUCTION: Massive pulmonary embolism (MPE) is a rare but highly fatal 
      condition. Our study's objective was to evaluate the association between advanced 
      interventions and survival among patients with MPE treated with venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO). METHODS: This is a retrospective 
      review of the Extracorporeal Life Support Organization (ELSO) registry data. We 
      included adult patients with MPE who were treated with VA-ECMO during 2010-2020. 
      Our Primary outcome was survival to hospital discharge; secondary outcomes were 
      ECMO duration among survivors and rates of ECMO-related complications. Clinical 
      variables were compared using the Pearson chi-square and Kruskal-Wallis H tests. 
      RESULTS: We included 802 patients; 80 (10%) received SPE and 18 (2%) received 
      CDT. Overall, 426 (53%) survived to discharge; survival was not significantly 
      different among those treated with SPE or CDT on VA-ECMO (70%) versus VA-ECMO 
      alone (52%) or SPE or CDT before VA-ECMO (52%). Multivariable regression found a 
      trend towards increased survival among those treated with SPE or CDT while on 
      ECMO (AOR 1.8, 95% CI 0.9-3.6), but no significant correlation. There was no 
      association between advanced interventions and ECMO duration among survivors, or 
      rates of ECMO-related complications. CONCLUSION: Our study found no difference in 
      survival in patients with MPE who received advanced interventions prior to ECMO, 
      and a slight non-significant benefit in those who received advanced interventions 
      while on ECMO.
FAU - Cardona, Stephanie
AU  - Cardona S
AUID- ORCID: 0000-0001-6588-4108
AD  - Department of Critical Care Medicine, The Mount Sinai Hospital, New York, NY, 
      USA. RINGGOLD: 5944
FAU - Downing, Jessica V
AU  - Downing JV
AD  - Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland 
      School of Medicine, Baltimore, MD, USA. RINGGOLD: 12264
FAU - Witting, Michael D
AU  - Witting MD
AD  - Department of Emergency Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA. RINGGOLD: 12264
FAU - Haase, Daniel J
AU  - Haase DJ
AUID- ORCID: 0000-0001-8950-1933
AD  - Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland 
      School of Medicine, Baltimore, MD, USA. RINGGOLD: 12264
AD  - Department of Emergency Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA. RINGGOLD: 12264
FAU - Powell, Elizabeth K
AU  - Powell EK
AUID- ORCID: 0000-0003-1258-5272
AD  - Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland 
      School of Medicine, Baltimore, MD, USA. RINGGOLD: 12264
AD  - Department of Emergency Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA. RINGGOLD: 12264
FAU - Dahi, Siamak
AU  - Dahi S
AD  - Department of Surgery, Division of Cardiac Surgery, University of Maryland School 
      of Medicine, Baltimore, MD, USA. RINGGOLD: 12264
FAU - Pasrija, Chetan
AU  - Pasrija C
AD  - Department of Cardiac Surgery, Vanderbilt University School of Medicine, 
      Nashville, TN, USA. RINGGOLD: 12327
FAU - Tran, Quincy K
AU  - Tran QK
AD  - Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland 
      School of Medicine, Baltimore, MD, USA. RINGGOLD: 12264
AD  - Department of Emergency Medicine, University of Maryland School of Medicine, 
      Baltimore, MD, USA. RINGGOLD: 12264
LA  - eng
PT  - Journal Article
DEP - 20230528
PL  - England
TA  - Perfusion
JT  - Perfusion
JID - 8700166
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - *Pulmonary Embolism/therapy/mortality
MH  - Male
MH  - Female
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Adult
MH  - Aged
OTO - NOTNLM
OT  - Extracorporeal membrane oxygenation
OT  - catheter directed thrombolysis
OT  - embolectomy
OT  - pulmonary embolism
OT  - survival
COIS- Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2023/05/29 00:42
MHDA- 2024/05/10 06:42
CRDT- 2023/05/28 22:22
PHST- 2024/05/10 06:42 [medline]
PHST- 2023/05/29 00:42 [pubmed]
PHST- 2023/05/28 22:22 [entrez]
AID - 10.1177/02676591231177909 [doi]
PST - ppublish
SO  - Perfusion. 2024 May;39(4):665-674. doi: 10.1177/02676591231177909. Epub 2023 May 
      28.