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Experience and results with VV-ECMO for severe acute respiratory failure: weaning vs. non-weaning.

Tuesday, November 25, 2014

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Lee, Yeon Joo; Kim, Dong Jung; Kim, Jun Sung; Lee, Jae-Ho; Lee, Choon-Taek; Jheon, Sanghoon; Cho, Young-Jae

In a retrospective review of 45 cases where patients were placed on VV ECMO, investigators from Seoul performed a multivariate analysis of pre-ECMO risk factors  that might be predictive of  an unsuccessful ECMO wean.  Notably, successful weaning from ECMO was only 46%, and overall survival was only 18%.   Importantly, higher platelet counts at ICU admission and the day prior to initiating ECMO were predictive of successful weaning.  Specifically, patients with a platelet count > 70K had an 11X greater likelihood of a successful wean.  Why?  Is the low platelet count a surrogate for the severity of illness?


Every patient is different. It is real interesting to know about platlet count and its role in weaning predictor.
With all due respect to the authors, it seems as though only 20 patients were successfully weaned--this number of events would permit only two risk factors to reasonably be included in the statistical model. This limitations warrants extreme caution in evaluation of the results.

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