Hemodynamic Improvement in Acute Respiratory Distress Syndrome Patients After Venovenous Extracorporeal Membrane Oxygenation Implantation.

OBJECTIVE

Severe acute respiratory distress syndrome (ARDS) is often complicated by hemodynamic instability requiring pharmacological support. Venovenous extracorporeal membrane oxygenation (VV ECMO) is a well-established technique that contributes to improved outcomes in this population. However, the effects of VV ECMO on inotropic and vasoconstrictor requirements have never been addressed in a large case series.

DESIGN

Observational study.

SETTING

University hospital.

PARTICIPANTS

Consecutive adult ARDS patients treated with VV ECMO.

MEASUREMENTS AND MAIN

RESULTS

From June 2009 to October 2023, 118 ARDS patients received VV ECMO and had available baseline data. The median patient age was 57 years, 65% of patients were male, and 76% had ongoing inotropic and/or vasoconstrictor support. Two hours after ECMO implantation, 61% of patients showed hemodynamic improvement, as documented by the reduced need for catecholaminergic support or increased mean arterial pressure with identical inotropic and/or vasoconstrictor support. This percentage increased to 63% at 12 hours, 83% at 24 hours, and 85% at 48 hours.

CONCLUSION

In the first 2 hours after VV ECMO implantation, hemodynamic improvement was observed in the majority of ARDS patients. This positive effect might therefore be considered in the decision-making process for VV ECMO implantation.