Increased trend in extracorporeal membrane oxygenation use by adults in the United States since 2007

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) has been increasingly studied as a life support modality, but it is unclear if its use has changed over time. Recent publication shows no significant trend in use of ECMO over time; however, this report does not include more recent data. We performed trend analysis to determine if and when the use of ECMO changed in the past decade.

Results: We identified hospitalizations (2000-2011) in the Nationwide Inpatient Sample during which ECMO was recorded. We used a segmented linear regression model to determine trend and to identify a temporal change point when rate of ECMO use increased. ECMO use gradually grew until 2007, at which time there was a dramatic increase in the rate (p = 0.0003). There was no difference in mortality after 2007 (p = 0.3374), but there was longer length of stay (p = 0.0001) and smaller percentage of women (p = 0.005).

Conclusions: There has been a marked increase in ECMO use since 2007. As ECMO use becomes more common, further study regarding indications, cost-effectiveness, and outcomes is warranted to guide optimal use.

Fig. 1

Semiannual incidence rates of hospitalizations of patients receiving extracorporeal membrane oxygenation in the United States 2000–2011 (Nationwide Inpatient Sample). The form of the fitted model is illustrated by the dashed line segments