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Table 1 Baseline characteristics and outcomes according to the timing of tracheostomy

From: Tracheostomy management in patients with severe acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: an International Multicenter Retrospective Study

 

All patients (n = 1168)

During ECMO tracheostomy (n = 353)

After ECMO tracheostomy (n = 177)

No tracheostomy (n = 638)

P

Age, years

48 ± 16

48 ± 15

48 ± 15

48 ± 16

0.77

Male sex

894 (76)

274 (78)

129 (73)

491 (77)

0.48

Body mass index, kg/m2

30 ± 9

30 ± 9

31 ± 8

30 ± 9

0.20

Chronic respiratory disease a

162 (14)

90 (25)

34 (19)

38 (6)#*

< 0.01

Immunodeficiency

177 (15)

77 (22)

34 (19)

66 (10)#*

< 0.01

SAPS II score

51 ± 18

50 ± 16

47 ± 17

53 ± 20*

0.01

SOFA at cannulation

10.5 ± 3.2

9.9 ± 2.8

10.1 ± 3.1

10.8 ± 3.4#*

< 0.01

RESP score

3.2 ± 2.9

2.8 ± 3.0

3.6 ± 2.8

3.2 ± 2.9

0.02

ARDS risk factor

    

< 0.01

 Bacterial pneumonia

564 (48)

177 (50)

68 (38)

319 (50)

 

 Viral pneumonia

195 (17)

69 (19)

49 (28)

77 (12)

 

 Pancreatitis

10 (1)

1 (0)

6 (3)

3 (0.5)

 

 Others

399 (44)

106 (31)

54 (31)

239 (38)

 

Post-operative ARDS (< 7 days)

245 (21)

77 (22)

61 (34)#

107 (17) *

< 0.01

Pre-ECMO ventilatory mechanic

 Respiratory rate, breaths/min

25 ± 7

26 ± 7

25 ± 8

25 ± 7

0.02

 Static compliance, ml/cmH2O

26 ± 12

25 ± 12

26 ± 12

26 ± 12

0.22

Pre-ECMO cardiac arrest

153 (13)

36 (10)

21 (12)

96 (15)

0.09

Pre-ECMO pneumothorax

96 (8)

49 (14)

26 (14)

21 (3)#*

< 0.01

Interval MV–ECMO, days

2 (1–6)

3 (1–7)

1 (1–4)

2 (1–6)

< 0.01

Venovenous-ECMO

1165 (100)

352 (100)

176(100)

637 (100)

0.38

 Femoral–jugular

997 (85)

293 (83)

151 (85)

553 (87)

 

 Femoral–femoral

50 (4)

17 (5)

12 (7)

21 (3)

 

 Dual lumen cannula

121 (10)

43 (12)

14 (8)

64 (10)

 

Pre-ECMO blood gases

 pH

7.23 ± 0.14

7.24 ± 0.13

7.23 ± 0.15

7.22 ± 0.14

0.16

 PaCO2, mmHg

66 ± 26

68 ± 29

63 ± 24

65 ± 25

0.15

 Arterial lactate, mmol/L

3.7 ± 3.7

2.9 ± 2.9

3.3 ± 3.0

4.1 ± 4.2#

< 0.01

 PaO2/FiO2, mmHg

72 ± 37

70 ± 32

70 ± 37

74 ± 40

0.35

Outcomes in ICU

 Renal replacement therapy

461 (39)

177 (50)

99 (56)

185 (29)#*

< 0.01

 ECMO duration, days

9 (5–16)

19 (11–30)

9 (6–13)#

7 (4–11)#*

< 0.01

 Mechanical ventilation duration, days

20 (11–34)

34 (22–49)

28 (21–38)#

13 (7–20)#*

< 0.01

 ICU LOS, days

25 (14–39)

37 (26–53)

36 (27–47)

16 (10–25)#*

< 0.01

 Hospital LOS, days

31 (18–49)

44 (31–64)

44 (32–58)

21 (13–35)#*

< 0.01

 Alive at hospital discharge

746 (64)

238 (67)

154 (87)#

354 (55)#*

< 0.01

  1. ARDS, acute respiratory distress syndrome; ECMO, extracorporeal membrane oxygenation; ICU, Intensive care unit; LOS, length of stay; MV, mechanical ventilation; PaCO2, partial pressure of arterial carbon dioxide; PaO2/FiO2, ratio of partial pressure of arterial oxygen to fraction of inspired oxygen; RESP, Respiratory ECMO Survival Prediction; SAPS II, simplified acute physiology score; SOFA Sequential Organ Failure Assessment
  2. Results are presented as n (%), mean ± standard deviation, or median (25th–75th percentiles); #, p value < 0.05 vs “tracheostomy during ECMO”; *, p value < 0.05 vs “after ECMO tracheostomy”
  3. aIncluding asthma, chronic interstitial lung disease, chronic obstructive lung disease, chronic restrictive lung disease, and obstructive sleep apnea
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