The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation
Abstract Background Veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) are crucial support modalities during lung transplantation, yet their comparative effectiveness remains unclear. Methods We conducted an 8-year retrospective analysis of 62 lung transplant recipi...
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BMC
2025-01-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03483-6 |
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| author | Sen Lu Pin Wang Xiao-qin Zhang Gang Feng Hong-li He Yue Chen Xiao-bo Huang Chun Pan Jing-chao Luo |
| author_facet | Sen Lu Pin Wang Xiao-qin Zhang Gang Feng Hong-li He Yue Chen Xiao-bo Huang Chun Pan Jing-chao Luo |
| author_sort | Sen Lu |
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| description | Abstract Background Veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) are crucial support modalities during lung transplantation, yet their comparative effectiveness remains unclear. Methods We conducted an 8-year retrospective analysis of 62 lung transplant recipients who received intraoperative ECMO (29 V-A, 33 V-V). Baseline characteristics, surgical parameters, and clinical outcomes were compared. To address potential selection bias, we employed entropy weighted inverse probability of treatment weighting (IPTW-EW). Results After IPTW-EW adjustment, V-A ECMO was associated with superior hemodynamic and respiratory parameters, including lower systolic pulmonary artery pressure (30 vs. 37 mmHg, p = 0.007), higher arterial oxygen partial pressure (119 vs. 78 mmHg, p = 0.002), and less severe pulmonary edema (Grade 1: 50% vs. 3%, Grade 2: 45% vs. 38%, Grade 3: 5% vs. 59%, p < 0.001). Notably, V-A ECMO demonstrated significantly lower 28-day (5% vs. 29%, p = 0.017) and hospital mortalities (21% vs. 69%, p = 0.035). Conclusions V-A ECMO provides superior pulmonary circulation unloading and is associated with improved survival outcomes compared to V-V ECMO in lung transplantation, suggesting its preferential use when clinically appropriate. |
| format | Article |
| id | doaj-art-4ae080b6cf0c4cd79820f05d978ebbc8 |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Pulmonary Medicine |
| spelling | doaj-art-4ae080b6cf0c4cd79820f05d978ebbc82025-01-26T12:12:58ZengBMCBMC Pulmonary Medicine1471-24662025-01-012511910.1186/s12890-025-03483-6The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantationSen Lu0Pin Wang1Xiao-qin Zhang2Gang Feng3Hong-li He4Yue Chen5Xiao-bo Huang6Chun Pan7Jing-chao Luo8Department of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Endocrinology, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Thoracic Surgery, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaSichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaDepartment of Critical Care Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, University of Electronic Science and Technology of ChinaAbstract Background Veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) are crucial support modalities during lung transplantation, yet their comparative effectiveness remains unclear. Methods We conducted an 8-year retrospective analysis of 62 lung transplant recipients who received intraoperative ECMO (29 V-A, 33 V-V). Baseline characteristics, surgical parameters, and clinical outcomes were compared. To address potential selection bias, we employed entropy weighted inverse probability of treatment weighting (IPTW-EW). Results After IPTW-EW adjustment, V-A ECMO was associated with superior hemodynamic and respiratory parameters, including lower systolic pulmonary artery pressure (30 vs. 37 mmHg, p = 0.007), higher arterial oxygen partial pressure (119 vs. 78 mmHg, p = 0.002), and less severe pulmonary edema (Grade 1: 50% vs. 3%, Grade 2: 45% vs. 38%, Grade 3: 5% vs. 59%, p < 0.001). Notably, V-A ECMO demonstrated significantly lower 28-day (5% vs. 29%, p = 0.017) and hospital mortalities (21% vs. 69%, p = 0.035). Conclusions V-A ECMO provides superior pulmonary circulation unloading and is associated with improved survival outcomes compared to V-V ECMO in lung transplantation, suggesting its preferential use when clinically appropriate.https://doi.org/10.1186/s12890-025-03483-6Lung transplantationExtracorporeal membrane oxygenationVeno-arterialVeno-venousPulmonary circulationMortality |
| spellingShingle | Sen Lu Pin Wang Xiao-qin Zhang Gang Feng Hong-li He Yue Chen Xiao-bo Huang Chun Pan Jing-chao Luo The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation BMC Pulmonary Medicine Lung transplantation Extracorporeal membrane oxygenation Veno-arterial Veno-venous Pulmonary circulation Mortality |
| title | The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| title_full | The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| title_fullStr | The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| title_full_unstemmed | The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| title_short | The superiority of veno-arterial over veno-venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| title_sort | superiority of veno arterial over veno venous extracorporeal membrane oxygenation for operative support of lung transplantation |
| topic | Lung transplantation Extracorporeal membrane oxygenation Veno-arterial Veno-venous Pulmonary circulation Mortality |
| url | https://doi.org/10.1186/s12890-025-03483-6 |
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