%0 Journal Article
%T National trends and outcomes for extra
%A Ahmed H Mohamed
%A Amgad Mentias
%A Ayman Elbadawi
%A Gbolahan O Ogunbayo
%A Igor Gosev
%A Islam Y Elgendy
%A Mohammed HZ Syed
%A Odunayo Olorunfemi
%A Scott J Cameron
%A Sunil Prasad
%J Vascular Medicine
%@ 1477-0377
%D 2019
%R 10.1177/1358863X18824650
%X Little is known about the temporal trends and outcomes for extra-corporeal membrane oxygenation (ECMO) in patients with high-risk pulmonary embolism (PE) in the United States. We queried the National Inpatient Sample (NIS) database from 2005 to 2013 to identify patients admitted with high-risk PE. Our objective was to determine trends for ECMO use in patients with high-risk PE. We also assessed in-hospital outcomes among patients with high-risk PE receiving ECMO. We evaluated 77,809 hospitalizations for high-risk PE. There was an upward trend in the utilization of ECMO from 0.07% in 2005 to 1.1% in 2013 (p = 0.015). ECMO was utilized more in urban teaching hospitals and large hospitals. ECMO use was associated with lower mortality in patients with massive PE (p < 0.001). In-hospital mortality for patients receiving ECMO was 61.6%, with no change over the observational period (p = 0.68). Our investigation revealed several independent predictors of increased mortality in patients with high-risk PE using ECMO as hemodynamic support, including: age, female sex, obesity, congestive heart failure, and chronic pulmonary disease. ECMO, therefore, as a rescue strategy or bridge to definitive treatment, may be effective in the management of high-risk PE when selecting patients with favorable clinical characteristics
%K extra-corporeal membrane oxygenation (ECMO)
%K high-risk pulmonary embolism (PE)
%K respiratory failure
%K shock
%U https://journals.sagepub.com/doi/full/10.1177/1358863X18824650