Acute cardiac care & resuscitationCohort study
Hyperoxia reflects poor native cardiac function and demonstrates cardiac index-dependent associations with mortality in veno-arterial extracorporeal membrane oxygenation patients
- single-centre retrospective cohort study
Authors' conclusion
The association between early hyperoxia and mortality in VA-ECMO is primarily driven by underlying cardiac failure rather than direct oxygen toxicity. The availability of advanced therapies further modifies this relationship, underscoring the need to account for both native cardiac output and heart replacement strategies when evaluating optimal PaO2 targets and the independent effect of hyperoxia on VA-ECMO outcomes.
Study context
- Population
- Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients
- Participants
- 227 VA-ECMO patients
- Exposure
- Hyperoxia (average PaO2) and native cardiac index in relation to intensive care unit (ICU) mortality, using multivariable regression and principal component analysis
Main finding
As reported in the abstract
Odds ratio
0.22
95% CI 0.06–0.70
P = 0.018
Observational data: associations, not effects.
Further findings
Association between hyperoxia and mortality after adjustment
- After adjusting for native cardiac index and utilization of advanced therapies, the association between hyperoxia and mortality became insignificant
Collinearity of average PaO2 and cardiac index
- Variance inflation factor (VIF), average PaO2
- 7.2
- VIF, cardiac index
- 11.5
- VIF, interaction term
- 20.3
- strongly inversely collinear
PC1 score distributions and haemodynamic profiles
- Non-survivors and survivors who received advanced therapies share similar PC1 score distributions and impaired haemodynamic profiles, including reduced ejection fraction, pulse pressures, and oxygen delivery indices
Original publication
Summarised from the published abstract; every number is checked against it