Complications during extracorporeal membrane oxygenation transfer in Argentina: A multicenter observational study

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2024-11-26 DOI:10.1111/aor.14914

Nestor Carrizo, Rafael Avila, Ivan Huespe, Aracelly Perez, Renzo Nuñez, Susana Bauque, Christian Casabella, Mariano Norese, Daniel Ivulich, Veronica Monzon, Fernando Pálizas, Sonia Villarroel

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引用次数: 0

Abstract

Background

There is a lack of documented cases regarding complications during ECMO transfer in middle-income countries. Using portable ECMO devices facilitates patient transport but entails significantly higher costs, necessitating evidence of their practical utility. This study aims to describe complications during ECMO transfer in Argentina and to compare complication rates between the integrated portable ECMO and non-portable ECMO systems.

Methods

A multicenter observational retrospective study was conducted across four high-complexity hospitals in Argentina. Patients over 18 years old who underwent ECMO transfer between January 2017 and July 2023 were included. Complications were classified based on the Ericsson severity classification, a widely accepted system that categorizes complications based on their severity and the need for immediate organ support. The effect of the ECMO systems (portable and non-portable ECMO system) on complication rates was assessed using logistic regression weighted by inverse probability weighting (IPWT) analysis after propensity score assessment to adjust for confounders.

Results

The study included 65 patients who were transferred for ECMO. Complications occurred in 40% (95%CI: 28%, 52%; n=26) of transfers, with grade 2 complications being the most prevalent at 20% (95%CI 11%, 32%; n=13). Integrated portable ECMO systems were associated with fewer complications during ECMO transfer, showing a crude OR of 0.25 (95%CI 0.08, 0.75), and after adjustment by IPWT, an OR of 0.27 (95%CI 0.08, 0.93).

Conclusions

ECMO transfers in middle-income countries exhibit complication rates similar to those in high-income countries. Our study found fewer complications in transfers using integrated portable ECMO systems and those involving distances exceeding 100 km. These findings suggest that the use of portable ECMO systems, despite their higher costs, may be beneficial in reducing complications during patient transport in middle-income countries.

查看原文本刊更多论文

阿根廷体外膜氧合转移过程中的并发症：一项多中心观察研究。

背景：在中等收入国家，缺乏有关 ECMO 转运过程中并发症的病例记录。使用便携式 ECMO 设备方便了患者转运，但成本明显增加，因此有必要证明其实际效用。本研究旨在描述阿根廷 ECMO 转运过程中的并发症，并比较综合便携式 ECMO 系统和非便携式 ECMO 系统的并发症发生率：在阿根廷的四家高复杂性医院开展了一项多中心观察性回顾研究。研究纳入了在 2017 年 1 月至 2023 年 7 月期间接受 ECMO 转运的 18 岁以上患者。并发症根据 Ericsson 严重程度分类法进行分类，这是一种广为接受的系统，根据并发症的严重程度和对即时器官支持的需求进行分类。在进行倾向性评分评估以调整混杂因素后，采用反概率加权（IPWT）逻辑回归分析评估了ECMO系统（便携式和非便携式ECMO系统）对并发症发生率的影响：研究纳入了 65 名转入 ECMO 的患者。40%（95%CI：28%，52%；n=26）的转院患者出现并发症，其中二级并发症发生率最高，为 20%（95%CI：11%，32%；n=13）。综合便携式 ECMO 系统与 ECMO 转运期间并发症较少有关，粗略 OR 为 0.25（95%CI 0.08，0.75），根据 IPWT 调整后，OR 为 0.27（95%CI 0.08，0.93）：结论：中等收入国家的 ECMO 转运并发症发生率与高收入国家相似。我们的研究发现，在使用一体化便携式 ECMO 系统和距离超过 100 公里的转运中，并发症较少。这些研究结果表明，尽管便携式 ECMO 系统的成本较高，但在中等收入国家使用该系统可能有利于减少患者转运过程中的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.