March 1, 2013Journal of ExtraCorporeal TechnologyOpen Access

Magnitude of Arterial Carbon Dioxide Change at Initiation of Extracorporeal Membrane Oxygenation Support Is Associated with Survival

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Why the study?

Does a large magnitude decrease in arterial carbon dioxide (≥25 mmHg) at ECMO initiation increase mortality in pediatric patients?

Structured PICO

Does a large magnitude decrease in arterial carbon dioxide (≥25 mmHg) at ECMO initiation increase mortality in pediatric patients?

Population

201 pediatric patients (age younger than 18 years, median age 10 days) undergoing extracorporeal membrane oxygenation (ECMO) for respiratory failure (51%), cardiac failure (23%), extracorporeal cardiopulmonary resuscitation (21%), or sepsis (5%) at a single tertiary care center.

Intervention

Large magnitude decrease in arterial carbon dioxide (delta-paCO2 ≥25 mmHg) at the initiation of ECMO support.

Comparator

Smaller magnitude change in arterial carbon dioxide (delta-paCO2 <25 mmHg) at the initiation of ECMO support.

Outcome

Patient survival to hospital discharge (mortality before discharge).hard clinical

A rapid, large-magnitude decrease in arterial carbon dioxide (≥25 mmHg) upon ECMO initiation is independently associated with increased mortality in pediatric patients, identifying a potentially modifiable target for ECMO management.

Limitations

Retrospective design
Single-center experience
Inconsistent application of neuroimaging limiting the ability to test the association between large delta-paCO2 and acute neurologic injury

Discussion

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Implication

Large paCO2 drops at pediatric ECMO initiation were associated with mortality; leaves open whether gradual correction improves outcomes.

Cite This Study

Bembea et al. (2013) studied this question.

synapsesocial.com/papers/6a7e2adc1bf3cbbc304f9747 https://doi.org/10.1051/ject/201345026

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Magnitude of Arterial Carbon Dioxide Change at Initiation of Extracorporeal Membrane Oxygenation Support Is Associated with Survival

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Magnitude of Arterial Carbon Dioxide Change at Initiation of Extracorporeal Membrane Oxygenation Support Is Associated with Survival

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider