Experience and results with VV-ECMO for severe acute respiratory failure: weaning vs. non-weaning. [1]
In a retrospective review of 45 cases where patients were placed on VV ECMO, investigators from Seoul performed a multivariate analysis of pre-ECMO risk factors that might be predictive of an unsuccessful ECMO wean. Notably, successful weaning from ECMO was only 46%, and overall survival was only 18%. Importantly, higher platelet counts at ICU admission and the day prior to initiating ECMO were predictive of successful weaning. Specifically, patients with a platelet count > 70K had an 11X greater likelihood of a successful wean. Why? Is the low platelet count a surrogate for the severity of illness?