Zhisheng Duan, Heping Xie, Huaping Zhong, Shuo Hu, Xu Chen, Ziyou Liu

Department of Critical Care II, First Affiliated Hospital of Gannan Medical College of Jiangxi Province, Ganzhou, People’s Republic of China

Correspondence: Ziyou Liu, Department of Critical Care II, The First Affiliated Hospital of Gannan Medical University, No. 23 of Qing Nian Avenue, Zhanggong District, Ganzhou, Jiangxi, 341000, People’s Republic of China, Tel +86 15297716789, Fax +0797-8269500, Email ziyoul74m@163.com

Purpose: This study aimed to investigate the predictors of successful weaning from veno-venous extracorporeal membrane oxygenation (VV-ECMO) among patients with severe acute respiratory distress syndrome (ARDS) in our centre.
Methods: The clinical data of patients with severe ARDS who were treated with VV-ECMO between January 2019 and January 2022 were retrospectively analysed. Due to the outcomes of weaning from extracorporeal membrane oxygenation (ECMO), the considered patients with ARDS were divided into a successful weaning group and an unsuccessful weaning group. Logistic regression analysis was employed to evaluate predictors for successful VV-ECMO weaning among patients with severe ARDS.
Results: A total of 65 patients with severe ARDS were included for analysis. Among them, 31 (47.69%) patients were grouped into the successful weaning group, while 34 (52.30%) patients were grouped into the unsuccessful weaning group. Univariate analysis showed that Age (odds ratio [OR] =0.939; 95% confidence interval [CI] =0.896– 0.983; p = 0.008), APACHEII scores before ECMO (OR =0.651; 95% CI =0.537– 0.789; p < 0.001), Renal insufficiency (OR =0.061; 95% CI =0.012 − 0.298; p = 0.001), MAP before ECMO (OR =1.246; 95% CI =1.114– 1.392; p< 0.001), PaO2 during ECMO (OR =1.083; 95% CI =1.033– 1.135; p = 0.001), and CRRT (OR =0.080; 95% CI =0.022– 0.285; p = 0.008) were identified as an independent predictor of successful VV-ECMO weaning. After multivariate analysis was performed, APACHE II scores before ECMO (OR = 0.651; 95% CI = 0.462– 0.919; p = 0.015) were identified as independent predictors for successful VV-ECMO weaning.
Conclusion: In conclusion, in severe ARDS patients, lower APACHE II scores predicted successful wean from VV-ECMO.

Keywords: acute respiratory distress syndrome, extracorporeal membrane oxygenation, predictor, weaning, acute physiology and chronic health evaluation II