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The following is a summary of “Role of age as eligibility criterion for ECMO in patients with ARDS: meta-regression analysis,” published in the August 2024 issue of Critical Care by Tonetti et al.
The use of age as an eligibility criterion for V-V ECMO has been a subject of broadly-rated debate and has varied across different healthcare institutions.
Researchers conducted a retrospective study to examine how age relates to mortality in patients undergoing V-V ECMO for ARDS.
They conducted a systematic review and meta-regression of clinical studies published between 2015 and June 2024; 6 patients with ARDS got treatment for V-V ECMO with specific data on ICU, and hospital mortality and patient age were included. The search strategy was executed in PubMed, limited to English-language articles. COVID-19 and non-COVID-19 populations were separately evaluated, along with that Meta-regressions related to age were performed, using gender, BMI, SAPS II, APACHE II, Charlson comorbidity index, or SOFA as covariates.
The results showed a significant positive association between mean age and ICU/hospital mortality in non-COVID ARDS. A significant relationship between mean age and ICU mortality was found in 103 studies of COVID-19 ARDS. Sensitivity analyses confirmed a linear relationship between age and mortality. There was an increase of 1.2% in non-COVID ARDS and 1.9% in COVID ARDS in ICU mortality for each mean year.
They concluded a linear relationship between age and ICU mortality with no inflection point. Therefore, no age cut-off can be recommended to determine patient eligibility for V-V ECMO.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05074-z
