Effect of low respiratory rate during extracorporeal membrane oxygenation on clinical outcomes in patients with acute respiratory distress syndrome
Fan Libin
Xi Donglei
Cheng Zihao
Cui Shukui
Zhang Zhanbo
Xi Guang
Zhao Zilu
Wang Yang
Abstract：Objective To study the effect of ventilator parameters during veno-venous extracorporeal membrane oxygenation (V-V ECMO) on the prognosis of patients with acute respiratory distress syndrome (ARDS). Methods Data of 50 ARDS patients treated with V-V ECMO at the Armed Police Hebei Provincial General Hospital or Hebei Provincial Chest Hospital between January 2018 and September 2023 were retrospectively analyzed. The study endpoint was 180-day mortality,and the effect of ventilator setting parameters on prognosis during the first 3 days after V-V ECMO support was analyzed. Results Twenty-four patients died within 180 d after ARDS. Age and Charlson comorbidity index were higher in the death group than in the survival group,whereas the V-V ECMO survival prediction score was lower than that of the survival group,with all P<0.05.Before V-V ECMO initiation,arterial carbon dioxide partial pressure was higher in the death group than in the survival group (P=0.044). On day 1 of V-V ECMO initiation,respiratory rate (RR) and tidal volume in the death group as well as the mean RR for the 3 days after V-V ECMO initiation and mechanical power were consistently higher than those in the survival group,with all P<0.05. A higher RR (P=0.003) on day 1 of V-V ECMO initiation was associated with higher mortality within 180 d. The RR of 13 beats/min had a sensitivity of 100.0％ for predicting 180-d mortality. Patients with mean RR>13 beats/min on day 1 or the first 3 days of ECMO support had a higher 180-d mortality (P<0.001 or P=0.048). Conclusion Patients with RR≤13 beats/min during V-V ECMO support may have better outcomes,but conclusions need to be justified.
Keywords：Extracorporeal membrane oxygenationAcute respiratory distress syndromeDeathRespiratory rate
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 445-450,458 )