Extracorporeal membrane oxygenation in life-threatening asthma unresponsive to mechanical ventilation: a comparison of patient demographics and outcomes between a large London-based intensive care unit and an international registry

Results and discussion

Ten patients (38.4 ± 13.6 years) were identified. Sixty per cent were known asthmatics, and 40% had previous hospital admissions for asthma. Eighty per cent had an infective trigger. The mean duration on ECMO and stay on intensive treatment unit (ITU) were 6.7 ± 2.9 days and 11.9 ± 5.3 days, respectively. Compared with the ELSO registry, there were no significant differences in patient demographics. Prior to ECMO, RBH patients were significantly more hypercapnic (16.0 vs 10.7 kPa, p=0.014), and were on a significantly less aggressive ventilator setting with regards to FiO₂ (57.1% vs 81.2%, p=0.002) and positive end-expiratory pressure (PEEP) (4.3 vs 8.3 kPa, p=0.043). However, there were no significant differences in survival (100% vs 83.5%, p=0.363) or duration on ECMO (6.7 vs 7.4 days, p=0.785). The pre-ECMO blood gas and ventilation settings could indicate a higher threshold for commencing ECMO in the RBH cohort, or the result of less aggressive ventilation settings prior to starting ECMO. However, this had no impact on survival and duration on ECMO.