Total Bilirubin as a Marker for Hemolysis and Outcome in ARDS Patients Treated with vvECMO

link.springer.com March 17, 2025

Patients with acute respiratory distress syndrome (ARDS), treatment with veno-venous ECMO and a total bilirubin (tBili) plasma concentration over the threshold of 3.6 mg/dl had significantly lower chances of survival, recovery from organ dysfunction, successful weaning from RRT, and successful weaning from treatment with ECMO within 28 days compared to patients with a tBili plasma concentration below 3.6 mg/dl.

The identified tBili-cut-off value might help to identify patients with ARDS and treatment with veno-venous ECMO with a high risk of unfavorable outcomes.

Retrospective analysis of patients with ARDS and vvECMO-therapy (n = 327) admitted to a tertiary ARDS center. A tBili cut-off value was determined by binary recursive partitioning.

Baseline characteristics were compared and relevant variables were included in a multivariate logistic regression model with backward variable selection. Primary endpoint was survival within 28 days analyzed with Kaplan–Meier-curves and cox regression.