RT Journal Article
SR Electronic
T1 Influence and complications of tracheotomy on V-V ECMO: a 10-year analysis
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 23
DO 10.1183/23120541.RFMVC-2020.23
VO 6
IS suppl 4
A1 Christoph Fisser
A1 Patricia Lüdtke
A1 Andreas Lüdtke
A1 Matthias Lubnow
A1 Maximilian V. Malfertheiner
A1 Alois Philipp
A1 Maik Foltan
A1 Dirk Lunz
A1 Thomas Müller
YR 2020
UL http://openres.ersjournals.com/content/6/suppl_4/23.abstract
AB Aim: Tracheotomy (surgical sTT, percutaneous pTT) is considered in long-term mechanical ventilation. Little is known on the influence and complications of TT on V-V ECMO.Methods: We analyzed 619 patients on V-V ECMO (2008-2017). TT was done on or after ECMO. Complications, ventilatory and ECMO settings were analyzed on and for two days after TT. Major bleeding was defined as drop of hemoglobin of ≥2g/dl/day and/or transfusion of 2≥RBC/day. Acute hypoxia or hypotension (drop of SpO2 of ≤85%, or BPsys ≤85mmHg within 30 minutes after TT), and pneumothorax were recorded. Sedation was assessed by RASS and dosing of sedating drugs.Results: TT on ECMO was done in 25% (14% dTT, 11% sTT) and in 14% after ECMO. Major/minor bleeding were higher on than after ECMO, while other complications were not different (Table 1a. In multivariate analysis TT on ECMO was attributed only to major bleeding (Table 1b).Between sTT and pTT, complications were similar (not shown).After TT, RASS and sedating drugs were decreased. PEEP and MPaw were reduced. While ECMO and sweep flow were reduced after TT, minute ventilation, tidal volume and respiratory rate increased (Table 2).Summary: Bleeding in tracheotomy was more common on than after ECMO while other complications were not. Complication rate was similar between sTT and pTT. TT resulted in lower sedation. Mean airway pressure, PEEP, ECMO and sweep flow were reduced while minute ventilation increased.FootnotesCite this article as: ERJ Open Research 2020; 6: Suppl. 4, 23.This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).