Table 1
Baseline Patient Characteristics by Type of ECMO Support
| VA ECMO | VV ECMO | p-Value | |
|---|---|---|---|
| Total Number | 64 | 58 | |
| Age, mean (SD), years | 55.4 (15.8) | 42.9 (16.2) | <0.0001 |
| Male sex, n (%) | 50 (78%) | 40 (70%) | 0.21 |
| White race, n (%) | 46 (79%) | 36 (71%) | 0.37 |
| BMI, mean (SD) | 32.9 (9.0) | 30.4 (8.1) | 0.30 |
| Smoking – No | 59 (92%) | 49 (84%) | 0.26 |
| Diabetes mellitus, n (%) | 4 (6%) | 6 (10%) | 0.52 |
| CAD, n (%) | 14 (22%) | 4 (7%) | 0.023 |
| HTN, n (%) | 16 (25%) | 15 (26%) | >0.99 |
| CKD, n (%) | 10 (16%) | 3 (5%) | 0.080 |
| Hyperlipidaemia, n (%) | 14 (22%) | 5 (9%) | 0.049 |
| COPD, n (%) | 7 (11%) | 6 (10%) | >0.99 |
| APACHE II, mean (SD) | 24.8 (7.9) | 28.0 (6.2) | 0.014 |
| Charlson Comorbidity Index, mean (SD) | 2.4 (2.7) | 1.8 (3.0) | 0.27 |
| Lactic acid, mean (SD), mmol/L | 7.4 (4.4) | 4.4 (3.2) | 0.0002 |
| ICU length of stay, mean (SD), days | 11.6 (10.8) | 24.5 (15.4) | <0.0001 |
| AKI, all stage, n (%) | 58 (91%) | 51 (88%) | 0.77 |
[i] SD – Standard Deviation, ECMO - Extra Corporeal Membrane Oxygenator, VA ECMO – Veno Arterial Extra Corporeal Membrane Oxygenator, VV ECMO – Veno Venous Extra Corporeal Membrane Oxygenator, CAD – Coronary Artery Disease, HTN- Hypertension, CKD – Chronic Kidney Disease, CHF – Congestive Heart Failure, COPD – Chronic Obstructive Pulmonary Disease, APACHE II - Acute Physiology, Age and Chronic Health Evaluation II, ICU – Intensive Care Unit, AKI – Acute Kidney Injury, RRT – Renal Replacement Therapy
Fig.1
Trends in mean serum creatinine by type of ECMO support
Fig. 2
Stages of acute kidney injury by type of ECMO support
Table 2
Distribution of Acute Kidney Injury Risk Factors
| Factor | VA ECMO | VV ECMO | Odds Ratio of AKI (95% CI) | p-value |
|---|---|---|---|---|
| IV contrast scan (%) | 37 (64%) | 33 (65%) | 0.96 (0.44, 2.11) | 0.92 |
| Cardiopulmonary Bypass (%) | 14 (24%) | 1 (2%) | 15.9 (2.0, 125.9) | 0.0088 |
| NSAID (%) | 9 (16%) | 15 (29%) | 0.44 (0.17, 1.12) | 0.085 |
| Antibiotics (%) | 32 (55%) | 29 (57%) | 0.93 (0.44, 1.99) | 0.86 |
| Sepsis (%) | 5 (9%) | 12 (24%) | 0.31 (0.10, 0.94) | 0.039 |
| Hypotension (%) | 49 (84%) | 35 (69%) | 2.49 (0.99, 6.28) | 0.053 |
| Vasopressor dependent Hypotension (%) | 38 (66%) | 31 (61%) | 1.23 (0.56, 2.68) | 0.61 |
| CHF (%) | 14 (24%) | 10 (20%) | 1.31 (0.52, 3.26) | 0.57 |
Table 3
Renal Outcomes by Type of ECMO Support
| VA ECMO | VV ECMO | p-value | |
|---|---|---|---|
| Complete Renal Recovery | 15 (26%) | 22 (43%) | 0.07 |
| Partial Renal Recovery | 5 (9%) | 3 (6%) | 0.72 |
| Dialysis Dependent | 1 (2%) | 1 (2%) | >0.99 |
| Death | 37 (64%) | 25 (49%) | 0.13 |
Supplemental Table 1
Primary Diagnosis of VA and VV ECMO groups
| Primary Diagnosis | VA ECMO | VV ECMO |
|---|---|---|
| Acute Coronary Syndrome | 27 | 0 |
| Congestive heart failure | 9 | 0 |
| Sepsis | 5 | 12 |
| Cardiac arrest | 5 | 0 |
| Valvular heart disease | 4 | 0 |
| Pulmonary embolism | 3 | 0 |
| Cardiac arrhythmias | 3 | 0 |
| Others | 8 | 15 |
| Pneumonia | 0 | 10 |
| Trauma | 0 | 10 |
| Viral Pneumonia | 0 | 5 |
| Drug Overdose | 0 | 3 |
| Acute Pancreatitis | 0 | 2 |
| Asthma | 0 | 1 |
[i] VA ECMO – Veno Arterial Extra Corporeal Membrane Oxygenator, VV ECMO – Veno Venous Extra Corporeal Membrane Oxygenator. Others in the VA ECMO group include heart transplant, thyrotoxico-sis, non-ischemic cardiomyopathy, aortic dissection, calcium channel blocker overdose, ventricular septal defect and myocarditis. Others in the VV ECMO group include hemothorax, lung contusion, vasculitis, sickle cell acute chest syndrome and pulmonary neoplasm.