Citation

Jouffroy R, Vivien B. Crit. Care 2023; 27(1).

Copyright

(Copyright © 2023, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13054-023-04624-1

PMID

unavailable

Abstract

We read with interest the recent research published in the Journal by Jasny et al. [1] reporting that survival among drowned adult and paediatric patients who received ECMO is lower than previously reported. Whereas the authors must be congratulated for this registry analysis, we believe that some points need to be emphasized in the interpretation of their results.

From a statistical point of view, it is surprising not to have compared patients cared for by cardiopulmonary resuscitation alone vs those with cardiopulmonary resuscitation plus ECMO. The latter are the most severe patients, consequently an adjustment including a prognostic score, i.e., SOFA or SAPS-2 [2, 3], would have been desirable in the multivariate analysis. Moreover, some potential confounders included in the multivariate logistic regression are censored, for example chronic pulmonary disease. As most patients received prehospital and in hospital cardiopulmonary resuscitation, OHCA outcome predictors could have been included in the multivariate logistic regression to take into account the CA characteristics impact on cardiopulmonary resuscitation results.

Language: en