Department of Anesthesiology and Intensive Care Medicine, University of Leipzig Medical Faculty, Leipzig, Germany.
Clinical Trial Centre, University of Leipzig, Leipzig, Germany.
PLoS One. 2021 Dec 7;16(12):e0260324. doi: 10.1371/journal.pone.0260324. eCollection 2021.
Extracorporeal Membrane Oxygenation (ECMO) use is increasing despite limited evidence. The aim of this study was to demonstrate heterogeneity of ECMO use and its association with hospital size and annual frequency in Germany.
This is a database analysis of all ECMO cases in Germany from 2010 to 2016 using the German Diagnosis Related Groups (DRG) coding system for ECMO.
During the study period, 510 hospitals performed 29,929 ECMO runs (12,572 vvECMO, 11,504 vaECMO, 1993 pECLA) with an increase over time. Mortality ranged between 58% and 66% for vaECMO cases and 66% and 53% for vvECMO cases. 304 (61%) hospitals performed only one ECMO per year. 78%% of all ECMO runs were performed in centres with more than 20 cases per year and more than half of all ECMO runs were performed in hospitals with >1.000 beds. Mortality for vv and vaECMO was highest in very small hospitals (< 200 beds; 70%; 74%) and very large hospitals (>1000 beds; 60%; 62%).
Use of ECMO is still increasing and a substantial proportion of hospitals performs very few ECMO runs. Small hospitals had a significantly higher mortality, but dependence on hospital size and ECMO mortality was irregular.
尽管证据有限，体外膜肺氧合（ECMO）的使用仍在增加。本研究旨在展示德国 ECMO 使用的异质性及其与医院规模和年频率的关系。
这是一项使用德国诊断相关组（DRG）编码系统对 2010 年至 2016 年德国所有 ECMO 病例的数据库分析。
在研究期间，510 家医院进行了 29929 例 ECMO 运行（12572 例 vvECMO、11504 例 vaECMO、1993 例 pECLA），随着时间的推移有所增加。vaECMO 病例的死亡率在 58%至 66%之间，vvECMO 病例的死亡率在 66%至 53%之间。304 家（61%）医院每年仅进行一次 ECMO。78%的所有 ECMO 运行都是在每年进行超过 20 例的中心进行的，超过一半的 ECMO 运行是在拥有>1000 张床位的医院进行的。vv 和 vaECMO 的死亡率在<200 张床位的小医院（70%；74%）和>1000 张床位的大医院（60%；62%）中最高。
ECMO 的使用仍在增加，很大一部分医院进行的 ECMO 运行次数非常少。小医院的死亡率明显较高，但对医院规模和 ECMO 死亡率的依赖是不规则的。
