Veno-Arterial Extracorporeal Life Support Use in Acute Pulmonary Embolism Shows Favorable Outcomes.

Differences in outcomes by indication for veno-arterial extracorporeal life support (VA-ECLS) are poorly described. We hypothesized that patients on VA-ECLS for acute pulmonary embolism (PE) have fewer complications and better survival than patients on VA-ECLS for other indications METHODS: All patients 18 years or older on VA-ECLS from the Extracorporeal Life Support Organization global registry (2010-2019) were evaluated (n=29,842). After excluding patients >79 years of age (n=729) and those with incomplete indication data (n=2,530), patients were stratified by VA-ECLS indication for PE versus all other indications. The association between being discharged alive and each type of complication with VA-ECLS indication was assessed RESULTS: Of 26,583 patients included in the analysis, 978 (3.7%) were on VA-ECLS for a primary diagnosis of acute PE. Acute PE patients were younger (53.1 versus 56.7 years, p<0.001), and were more likely to be female (52.1% versus 32.3%, p<0.001). Patients who underwent VA-ECLS for acute PE were 78% more likely to be discharged alive versus VA-ECLS supported patients for other reasons (p<0.001). Acute PE patients had fewer cardiovascular and renal complications (26.6% versus 38.0% and 31.1% versus 39.4% respectively, adjusted p<0.001). Acute PE patients were found to have higher odds of having clots and mechanical complications (8.7% versus 7.9% and 16.7% versus 14.6% respectively, adjusted p<0.001) CONCLUSIONS: Patients undergoing VA-ECLS for acute PE have higher odds of survival to hospital discharge compared to those supported for other indications. Additionally, VA-ECLS in this population is associated with less cardiovascular and renal complications but higher mechanical complications.