Abstract
BACKGROUND: Treatment of acute respiratory distress syndrome (ARDS) with extracorporeal membrane oxygenation (ECMO) remains controversial. OBJECTIVE: This study aims to examine outcomes in ARDS patients treated with or without ECMO. METHODS: Using the National Inpatient Sample (NIS) database, all ARDS patients including those who were treated with ECMO were included in the analysis. Univariable and multivariable logistic regressions were used to estimate the odds of in-hospital outcomes between groups. RESULTS: A total of 2,540,350 patients were identified (2,538,849 with ARDS; 1,501 with ARDS on ECMO). The patients who underwent ECMO included younger patients and more men. Using ECMO in ARDS patients was associated with higher in-hospital mortality, cardiopulmonary arrest, major bleeding, sepsis, acute kidney injury, and longer hospital stays (31.7 vs. 8.3 days; p < 0.001 for all). A subgroup analysis based on age and sex had similar outcomes. CONCLUSION: Using ECMO in patients with ARDS was associated with worse in-hospital outcomes, including mortality and length of stay.