326: ASSOCIATION BETWEEN PARENTERAL NUTRITION AND OXYGEN MEMBRANE DYSFUNCTION IN ADULTS REQUIRING ECMO

Introduction: Extracorporeal life support is influenced by membrane integrity and nutrition. The impact of parenteral nutrition with lipid injectable emulsions on membrane function remains uncertain. This study evaluates whether parenteral nutrition with lipids increases oxygenator membrane dysfunction in adult ECMO patients. Methods: This retrospective cohort included li critically ill adults on extracorporeal life support at a single center (Feb 2022–Dec 2023). Patients were classified based on exposure to parenteral nutrition: those exposed to parenteral nutrition (n=38, 25%) and those not exposed to parenteral nutrition (n=113, 75%). Data included demographics, clinical, biochemical, and Extracorporeal Membrane Oxygenation -related variables. Our primary outcome was first oxygenator membrane dysfunction; secondary outcomes were Extracorporeal life support duration, metabolic changes and transfusion needs, analyzed with Kaplan-Meier curves and Cox models. Results: Oxygen membrane lifespan was similar between groups (8.5 vs. 7 days, p=0.079). Replacement occurred in 18 patients (11.9%): 7 (18.4%) with parenteral nutrition and 11 (9.7%) without. Multivariate analysis showed a hazard ratio of 2.35 for membrane replacement in parenteral nutrition patients (CI 0.71–7.69, p=0.157). The parenteral nutrition group had higher D-dimer (3470 vs. 650 ng/mL, p=0.06), lower fibrinogen (159 vs. 308 mg/dL, p=0.05), longer extracorporeal life support duration (10 vs. 7 days, p=0.047), and greater transfusion needs. Parenteral nutrition was also linked to elevated peak triglycerides (352 vs. 261 mg/dL, p< 0.01) and lower HDL (14.5 vs. 22 mg/dL, p< 0.01). However, these metabolic changes did not significantly impact membrane replacement (HR 0.99, CI 0.99–1.00, p=0.817). Conclusions: Although membrane dysfunction seemed more frequent in the parenteral nutrition group, evidence was insufficient to confirm an association, underscoring the need for further research.