{
  "abstract": "Background Evidence supporting venoarterial extracorporeal membrane oxygenation (VA-ECMO) in Category E pulmonary thromboembolism (PTE) under the 2026 American Heart Association/American College of Cardiology guideline remains limited. We evaluated associations with 30-day mortality and in-hospital major bleeding.Methods This multicentre retrospective cohort included consecutive patients with Category E PTE admitted to four tertiary centres in Southwest China from January 2019 to August 2025. Primary outcomes were 30-day all-cause mortality and in-hospital major bleeding. Mortality was evaluated using Kaplan-Meier analysis and Cox regression. Major bleeding was analysed using Fine-Gray regression with death before bleeding as a competing event.Results Among 95 patients, 39 received VA-ECMO and 56 did not. 30-day mortality was 43.6% and 62.5%, respectively. VA-ECMO was associated with lower mortality in the multivariable model (adjusted HR 0.44, 95% CI 0.22 to 0.88). Major bleeding occurred in 35.9% of VA-ECMO recipients and 16.1% of patients without VA-ECMO (unadjusted subdistribution HR (sHR) 2.50, 95% CI 1.11 to 5.64; p=0.027). The adjusted association was not statistically significant (sHR 1.18, 95% CI 0.44 to 3.12; p=0.743).Conclusions In patients with Category E PTE, VA-ECMO was associated with lower 30-day mortality after adjustment for baseline differences. Although in-hospital major bleeding was more frequent among VA-ECMO recipients in unadjusted analyses, this association was not statistically significant after multivariable adjustment. Cardiac arrest and baseline creatinine and fibrinogen levels were independently associated with major bleeding.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, Guang’an People’s Hospital, Guang’an, China",
    "Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China",
    "Key Laboratory of Laboratory Medical Diagnostics of Ministry of Education, Chongqing Medical University, Chongqing, China",
    "Army Medical Center of PLA, Chongqing, China"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jian Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaohui Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Hong Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Yi Yan"
    },
    {
      "affs": [
        2
      ],
      "name": "Qin Hu"
    },
    {
      "affs": [
        1
      ],
      "name": "Yifan Zhao"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhuoya Ma"
    },
    {
      "affs": [
        3
      ],
      "name": "Bingling He"
    },
    {
      "affs": [
        1
      ],
      "name": "Shengxin Fan"
    },
    {
      "affs": [
        1
      ],
      "name": "Huaxiao Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ebjsg0x85apd3.bib",
  "cited_by": 0,
  "doi": "10.1136/bmjresp-2026-004738",
  "fulltext_url": "https://bmjopenrespres.bmj.com/content/13/1/e004738.full",
  "id": "ebjsg0x85apd3",
  "issns": [
    "2052-4439"
  ],
  "landing_url": "https://doi.org/10.1136/bmjresp-2026-004738",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
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      "lcc",
      "RC705-779"
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      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
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  "pdf_url": "https://bmjopenrespres.bmj.com/content/13/1/e004738.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-08",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/ebjsg0x85apd3.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T14:21:26Z",
      "native_id": "51ea97d922c2458cb4a922418c8d6852",
      "source": "doaj",
      "url": "https://doi.org/10.1136/bmjresp-2026-004738"
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  "subjects": [
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      "field": "medicine",
      "origin": "openalex:2724|Venous Thromboembolism Diagnosis and Management",
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  ],
  "title": "Effectiveness and major bleeding complications with venoarterial extracorporeal membrane oxygenation in category E pulmonary thromboembolism: a multicentre retrospective study",
  "title_text": "Effectiveness and major bleeding complications with venoarterial extracorporeal membrane oxygenation in category E pulmonary thromboembolism: a multicentre retrospective study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T14:21:26Z",
  "url": "https://research.draconitic.com/paper/ebjsg0x85apd3",
  "venue": "BMJ Open Respiratory Research",
  "versions": []
}