Direct hyperbilirubinemia (DHB) caused by extracorporeal membrane oxygenation (ECMO) is most likely multifactorial. For a study, researchers sought to determine the frequency and risk factors for developing direct hyperbilirubinemia while on ECMO, as well as the impact on infant mortality. Between January 2010 and January 2020, they conducted retrospective research. They identified youngsters (18 years) who needed veno-arterial (VA) ECMO assistance using the Mayo Clinic electronic health record. Demographic information, ECMO indication, laboratory data, and outcomes were gathered. At the time of admission, illness acuity scores, including the vasoactive-inotropic score (VIS), were employed to determine disease severity. The study population was separated into two groups: those who developed direct hyperbilirubinemia (DHB) while on ECMO and those who did not (control). DHB was defined as direct bilirubin (DB) levels of more than 1.0 mg/dL. The two groups’ disease acuity and death rates were compared. Logistic regression was used to assess the risk of death in the absence of any confounding factors.

During the trial period, they identified 106 children who required ECMO assistance. On ECMO, 36 (34%) of the youngsters developed DHB. On ECMO day 2 (P=0.046) and day 7 (P=0.01), the DHB group had substantially higher illness acuity scores. The mortality rate in the DHB group was 72% against 29% in the control group (P<0.001). DHB was linked to a greater death rate compared to the control group.