Abstract
BackgroundExtracorporeal 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.ResultsWe 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).ConclusionsThere 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.
Highlights
Extracorporeal membrane oxygenation (ECMO) has been increasingly studied as a life support modality, but it is unclear if its use has changed over time
We identified all hospitalizations in adults 18 years of age and older from January 2000 through December 2011 during which either a primary or secondary procedure of ECMO was recorded
Upon inspection of the autocorrelation function and partial autocorrelation function, we found no evidence of temporal correlation, implying that a segmented linear regression model based on independent errors is sufficient to model the incidence of ECMO use
Summary
The objective of this study was to determine how the national frequency of ECMO use has changed over the past decade in the United States (US) with a larger number of years of data than previously reported, and to determine the point in time point at which the use may have changed
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