ECMO use in Germany: An analysis of 29,929 ECMO runs

• DOI: 10.1371/journal.pone.0260324
• Publication Date: 2021-12-07T18:33:06Z
• Authors: Sven Bercker; David Petroff; Nina Polze; Christian Karagia...; Thomas Bein; Sven Laudi; Sebastian N. Stehr; Maria Theresa Voe...
• Keywords: Adult; Aged, 80 and over; Health Facility Size; Male; Databases, Factual; Science; Q; R; Middle Aged; 3. Good health; Young Adult; 03 medical and health sciences; Extracorporeal Membrane Oxygenation; 0302 clinical medicine; Germany; Medicine; Humans; Female; Hospital Mortality; Diagnosis-Related Groups; Research Article; Aged; Retrospective Studies

Background Extracorporeal Membrane Oxygenation (ECMO) use is increasing despite limited evidence. The aim of this study was to demonstrate heterogeneity of ECMO use and its association with hospital size and annual frequency in Germany.

Methods This is a database analysis of all ECMO cases in Germany from 2010 to 2016 using the German Diagnosis Related Groups (DRG) coding system for ECMO.

Results During the study period, 510 hospitals performed 29,929 ECMO runs (12,572 vvECMO, 11,504 vaECMO, 1993 pECLA) with an increase over time. Mortality ranged between 58% and 66% for vaECMO cases and 66% and 53% for vvECMO cases. 304 (61%) hospitals performed only one ECMO per year. 78%% of all ECMO runs were performed in centres with more than 20 cases per year and more than half of all ECMO runs were performed in hospitals with >1.000 beds. Mortality for vv and vaECMO was highest in very small hospitals (< 200 beds; 70%; 74%) and very large hospitals (>1000 beds; 60%; 62%).

Conclusions Use of ECMO is still increasing and a substantial proportion of hospitals performs very few ECMO runs. Small hospitals had a significantly higher mortality, but dependence on hospital size and ECMO mortality was irregular.