Acute cardiac care & resuscitation
Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Mortality in Patients With Cardiogenic Shock
Authors' conclusion
Exposure to hyperoxia during venoarterial ECMO support for cardiogenic shock is strongly associated with increased in-hospital mortality, independent from hemodynamic and ventilatory status.
Study context
- Population
- Patients receiving venoarterial extracorporeal membrane oxygenator (ECMO) for cardiogenic shock, excluding extracorporeal CPR, Extracorporeal Life Support Organization Registry, 2010–2020
- Participants
- 9,959 patients
- Exposure
- Hyperoxia vs normoxia after 24 h of venoarterial ECMO
- Mild hyperoxian = 3,005
- Severe hyperoxian = 1,972
- Outcome
- In-hospital mortality
Methodological detailsregistry-based, multivariable logistic regression
- Registry-based
- Multivariable logistic regression
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)P value
Mild hyperoxiavs Normoxia
1.37(1.23–1.53)
P < 0.001Severe hyperoxiavs Normoxia
2.20(1.92–2.52)
P < 0.001PaO2 per 50 mmHg higherper 50 mmHg higher PaO2
1.14(1.12–1.16)
P < 0.001Observational data: associations, not effects.
Further findings
In-hospital mortality by subgroup and stratified by ventilator settings, airway pressures, acid-base status and other clinical variables
- Higher PaO2 associated with increased in-hospital mortality in each subgroup and stratum
Predictors of in-hospital mortality (random forest model)
- PaO2 second strongest predictor, after older age
Original publication
Exposure to Arterial Hyperoxia During Extracorporeal Membrane Oxygenator Support and Mortality in Patients With Cardiogenic Shock. Circ Heart Fail. Published 5 March 2023. doi:10.
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