Veno‐venous extracorporeal membrane oxygenation for septic shock patients with pulmonary infection: A propensity score matching‐based retrospective study

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Abstract
Objective: To evaluate whether septic shock patients with pulmonary infection and life‐threatening hypoxemia can benefit from V‐V ECMO. Methods: Retrospective clinical data analysis on patients who suffered septic shock with pulmonary infection, categorized into V‐V ECMO and control groups. The propensity score matching (PSM) method was used to screen patients matched for age, gender, and disease severity. The primary outcome was 30‐ and 90‐day mortality after diagnosis of septic shock. Results: After PSM, 31 pairs of patients were enrolled in this study, and there were no significant differences between the two groups in terms of gender, age, chronic disease, acute physiological and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score. Within 28 days after the diagnosis of septic shock, the median time of renal replacement therapy‐free days was longer in the V‐V ECMO group than in the control group (27 days vs. 9 days; p = 0.044). Kaplan–Meier analysis showed that 30‐day mortality was lower in the V‐V ECMO group than in the control group (38.7% vs. 61.3%; HR 0.488; 95% CI 0.240–0.992; p = 0.043, by log‐rank test); 90‐day mortality was not significantly different between the two groups (51.6% vs. 67.7%, p = 0.097). Conclusion: Patients receiving V‐V ECMO support had lower 30‐day mortality and faster recovery of renal function within 28 days compared with those receiving conventional therapy. However, V‐V ECMO did not improve 90‐day survival in septic shock patients with pulmonary infection.

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