# Impact of different parameters on the outcome of vv-ECMO therapy in burn patients – a retrospective cohort study from a burn and high output ECMO center

## TL;DR

This study examines factors affecting survival in burn patients treated with vv-ECMO for ARDS, finding high mortality linked to complications like MODS and renal failure.

## Contribution

The study identifies specific clinical parameters associated with survival in burn patients undergoing vv-ECMO therapy.

## Key findings

- A mortality rate of 76% was observed in burn patients treated with vv-ECMO.
- Higher TBSA, lower pH levels, MODS, and renal insufficiency were linked to worse outcomes.
- ECMO should be used in specialized burn centers due to high complication risks.

## Abstract

The treatment of acute respiratory distress syndrome (ARDS) in burn patients remains a major challenge. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) is a standard treatment for severe ARDS today. But reports on survival outcome in burn patients remain variable in the literature. The aim of this study is to identify factors that may influence survival and therapy outcomes in this distinct patient population.

A single-center retrospective study was conducted in the burn intensive care unit (BICU). Inclusion criteria were the use of vv-ECMO for ARDS after burn injuries. The data analyzed included general medical data and various parameters from the BICU.

Between January 2012 and December 2022, 21 consecutive adult patients were identified who underwent vv-ECMO treatment. Five patients (24 %) survived the therapy and could be discharged, and 16 patients (76 %) succumbed to their disease. A higher TBSA affected, lower pH in arterial blood gas analysis after 24 and 36 h, multiorgan dysfunction syndrome (MODS), renal insufficiency, and renal replacement therapy were significantly associated with a lethal outcome.

The data from the present study showed an overall mortality rate of 76 %, which is unsatisfactory compared to the literature. This could be explained by complicating factors such as MODS, renal failure, and renal replacement therapy. However, the indication for vv-ECMO must be adapted to the individual situation of the respective patient. Due to the additional higher risk for complications, the utilization of ECMO therapy should be reserved for specialized burn centers with an interdisciplinary setting.