Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support
Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used in patients with cardiopulmonary collapse, but data regarding its use in pregnancy is limited. We aimed to identify the clinical characteristics and predictors of in-hospital mortality in female patients requiring VA-ECMO...
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Elsevier
2025-07-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425001201 |
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| author | Trishna Parikh Sabiha Armin Saad Afzal Khan Adishwar Rao Akriti Agrawal Dev Patel Bindu Akkanti |
| author_facet | Trishna Parikh Sabiha Armin Saad Afzal Khan Adishwar Rao Akriti Agrawal Dev Patel Bindu Akkanti |
| author_sort | Trishna Parikh |
| collection | DOAJ |
| description | Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used in patients with cardiopulmonary collapse, but data regarding its use in pregnancy is limited. We aimed to identify the clinical characteristics and predictors of in-hospital mortality in female patients requiring VA-ECMO, including evaluating the role of pregnancy. Methods: In this cross-sectional study, a cohort of female patients aged 19–45 years who required VA-ECMO were identified from the National Inpatient Sample from 2018 to 2021 and further stratified according to presence of pregnancy-associated diagnoses. Baseline characteristics were compared using Pearson chi-square test and Wilcoxon rank-sum test for categorical and continuous variables, respectively. Multivariate analysis using a logistic regression model was performed to identify predictors of in-hospital mortality in the entire cohort. Subgroup analyses were done in patients with coronavirus disease 2019 (COVID-19). Results: Of 2,010 female patients requiring VA-ECMO, 255 (12.7%) had a pregnancy-associated diagnosis. Cardiogenic shock was more common among patients without a pregnancy-associated diagnosis. There was no difference in in-hospital mortality between the two groups (p = 0.15). Infectious complications (adjusted odds ratio [OR]: 1.72 [1.01–2.93], p = 0.05) were positively associated with in-hospital mortality. Pregnancy-associated diagnoses were not associated with survival (OR: 0.51 [0.21–1.25], p = 0.14) in the entire cohort or in a subgroup of patients with COVID-19 (OR: 0.30 [0.01–19.01], p = 0.52). Conclusions: VA-ECMO remains a feasible option in patients with pregnancy-associated diagnoses requiring mechanical circulatory support. Infection control is required to decrease the associated in-hospital mortality. |
| format | Article |
| id | doaj-art-d4b593a04fb2420d8b3873e8d3d2aec4 |
| institution | OA Journals |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-d4b593a04fb2420d8b3873e8d3d2aec42025-08-20T02:02:48ZengElsevierResuscitation Plus2666-52042025-07-012410098310.1016/j.resplu.2025.100983Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory supportTrishna Parikh0Sabiha Armin1Saad Afzal Khan2Adishwar Rao3Akriti Agrawal4Dev Patel5Bindu Akkanti6Department of Internal Medicine, Case Western Reserve University/University Hospitals, Cleveland, OH, USADepartment of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USASchool of Public Health at The University of Texas Health Science Center at Houston, Houston, TX, USASchool of Public Health at The University of Texas Health Science Center at Houston, Houston, TX, USADepartment of Internal Medicine, Case Western Reserve University/University Hospitals, Cleveland, OH, USADivision of Critical Care, Pulmonary and Sleep Medicine, Department of Internal Medicine at The University of Texas Health Science Center at Houston, Houston, TX, USA; Advanced Cardiopulmonary Therapeutics and Transplantation, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA; Corresponding author at: Divisions of Critical Care, Pulmonary and Sleep Medicine, Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used in patients with cardiopulmonary collapse, but data regarding its use in pregnancy is limited. We aimed to identify the clinical characteristics and predictors of in-hospital mortality in female patients requiring VA-ECMO, including evaluating the role of pregnancy. Methods: In this cross-sectional study, a cohort of female patients aged 19–45 years who required VA-ECMO were identified from the National Inpatient Sample from 2018 to 2021 and further stratified according to presence of pregnancy-associated diagnoses. Baseline characteristics were compared using Pearson chi-square test and Wilcoxon rank-sum test for categorical and continuous variables, respectively. Multivariate analysis using a logistic regression model was performed to identify predictors of in-hospital mortality in the entire cohort. Subgroup analyses were done in patients with coronavirus disease 2019 (COVID-19). Results: Of 2,010 female patients requiring VA-ECMO, 255 (12.7%) had a pregnancy-associated diagnosis. Cardiogenic shock was more common among patients without a pregnancy-associated diagnosis. There was no difference in in-hospital mortality between the two groups (p = 0.15). Infectious complications (adjusted odds ratio [OR]: 1.72 [1.01–2.93], p = 0.05) were positively associated with in-hospital mortality. Pregnancy-associated diagnoses were not associated with survival (OR: 0.51 [0.21–1.25], p = 0.14) in the entire cohort or in a subgroup of patients with COVID-19 (OR: 0.30 [0.01–19.01], p = 0.52). Conclusions: VA-ECMO remains a feasible option in patients with pregnancy-associated diagnoses requiring mechanical circulatory support. Infection control is required to decrease the associated in-hospital mortality.http://www.sciencedirect.com/science/article/pii/S2666520425001201In-hospital mortalityMaternal mortalityNational Inpatient SamplePregnancyVenoarterial extracorporeal membrane oxygenation |
| spellingShingle | Trishna Parikh Sabiha Armin Saad Afzal Khan Adishwar Rao Akriti Agrawal Dev Patel Bindu Akkanti Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support Resuscitation Plus In-hospital mortality Maternal mortality National Inpatient Sample Pregnancy Venoarterial extracorporeal membrane oxygenation |
| title | Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support |
| title_full | Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support |
| title_fullStr | Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support |
| title_full_unstemmed | Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support |
| title_short | Venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy-associated diagnoses who require mechanical circulatory support |
| title_sort | venoarterial extracorporeal membrane oxygenation is a feasible option for patients with pregnancy associated diagnoses who require mechanical circulatory support |
| topic | In-hospital mortality Maternal mortality National Inpatient Sample Pregnancy Venoarterial extracorporeal membrane oxygenation |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425001201 |
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