Improving Veno-Veno Extracorporeal Membrane Oxygenation (VV ECMO) Survival to Discharge by Implementing a Goal-Oriented Expected Progression Patient Management Guideline

ABSTRACT

Management of VV ECMO has substantially evolved over the past two decades. Plenty literature has been published regarding indications, management, and outcomes, however limited evidence of standardized goal-oriented management practices exists. The VV ECMO Expected Progression guideline, approved on March 1, 2021 by the institution's ECMO Steering Committee, consists of five goal-oriented phases with suggestive interventions. Patient characteristics and outcomes were collected retrospectively and compared between July 2019 to Feb 2021 ("pre-implementation group") and March 2021 to April 2022 ("post implementation group"). Chi Square tests were performed to analyze the primary outcomes. Patient characteristics and outcomes are shown in table 1. Out of 125 adult patients, 78 followed the VV ECMO expected progression guideline. There was no significant difference in patient age, sex, and body mas index between both groups. COVID ARDS was the primary ECMO indicator for both cohorts at 96% (75/78) and 68% (32/47) respectively. Pre-ECMO presentation characteristics were evenly distributed between both groups. ECMO duration, ICU length of stay (LOS), and hospital LOS were significantly longer in the post implementation group (p=<0.01). ICU survival and hospital discharge outcome measures demonstrated a statistically significant improvement of 23.3% (p=<0.01) in the post implementation group. The VV ECMO Expected Progression goal-oriented guideline demonstrated to be a useful tool that resulted in streamlined care and improved survival to discharge. Of note, the post implementation group did report an increased in ECMO run time, ICU and hospital LOS. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)