Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in Postcardiotomy Cardiogenic Shock

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F21%3A00081487" target="_blank" >RIV/00023001:_____/21:00081487 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.sciencedirect.com/science/article/pii/S1053077020311794?via%3Dihub#sec0007" target="_blank" >https://www.sciencedirect.com/science/article/pii/S1053077020311794?via%3Dihub#sec0007</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1053/j.jvca.2020.11.003" target="_blank" >10.1053/j.jvca.2020.11.003</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in Postcardiotomy Cardiogenic Shock

Popis výsledku v původním jazyce

Objective: The optimal duration of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients affected by postcardiotomy cardiogenic shock (PCS) remains controversial. The present study was conducted to investigate the effect of VA-ECMO duration on hospital outcomes. Design: Retrospective analysis of an international registry. Setting: Multicenter study including 19 tertiary university hospitals. Participants: Between January 2010 and March 2018, data on PCS patients receiving VA-ECMO were retrieved from the multicenter PC-ECMO registry. Interventions: Patients were stratified according to the following different durations of VA-ECMO therapy: &lt;= three days, four-to-seven days, eight-to-ten days, and &gt;ten days. Measurements and Main Results: A total of 725 patients, with a mean age of 62.9 +/- 12.9 years, were included. The mean duration of VA-ECMO was 7.1 +/- 6.3 days (range 0-39 d), and 39.4% of patients were supported for &lt;= three days, 29.1% for four-seven days, 15.3% for eightten days, and finally 20.7% for &gt;ten days. A total of 391 (53.9%) patients were weaned from VA-ECMO successfully; however, 134 (34.3%) of those patients died before discharge. Multivariate logistic regression showed that prolonged duration of VA-ECMO therapy (four-seven days: adjusted rate 53.6%, odds ratio [OR] 0.28, 95% confidence interval [CI] 0.18-0.44; eight-ten days: adjusted rate 61.3%, OR 0.51, 95% CI 0.29-0.87; and &gt;ten days: adjusted rate 59.3%, OR 0.49, 95% CI 0.31-0.81) was associated with lower risk of mortality compared with VA-ECMO lasting &lt;= three days (adjusted rate 78.3%). Patients requiring VA-ECMO therapy for eight-ten days (OR 1.96, 95% CI 1.15-3.33) and &gt;10 days (OR 1.85, 95% CI 1.14-3.02) had significantly greater mortality compared with those on VA-ECMO for 4 to 7 days. Conclusions: PCS patients weaned from VA-ECMO after four-seven days of support had significantly less mortality compared with those with shorter or longer mechanical support. (C) 2020 Elsevier Inc. All rights reserved.

Název v anglickém jazyce

Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in Postcardiotomy Cardiogenic Shock

Popis výsledku anglicky

Objective: The optimal duration of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients affected by postcardiotomy cardiogenic shock (PCS) remains controversial. The present study was conducted to investigate the effect of VA-ECMO duration on hospital outcomes. Design: Retrospective analysis of an international registry. Setting: Multicenter study including 19 tertiary university hospitals. Participants: Between January 2010 and March 2018, data on PCS patients receiving VA-ECMO were retrieved from the multicenter PC-ECMO registry. Interventions: Patients were stratified according to the following different durations of VA-ECMO therapy: &lt;= three days, four-to-seven days, eight-to-ten days, and &gt;ten days. Measurements and Main Results: A total of 725 patients, with a mean age of 62.9 +/- 12.9 years, were included. The mean duration of VA-ECMO was 7.1 +/- 6.3 days (range 0-39 d), and 39.4% of patients were supported for &lt;= three days, 29.1% for four-seven days, 15.3% for eightten days, and finally 20.7% for &gt;ten days. A total of 391 (53.9%) patients were weaned from VA-ECMO successfully; however, 134 (34.3%) of those patients died before discharge. Multivariate logistic regression showed that prolonged duration of VA-ECMO therapy (four-seven days: adjusted rate 53.6%, odds ratio [OR] 0.28, 95% confidence interval [CI] 0.18-0.44; eight-ten days: adjusted rate 61.3%, OR 0.51, 95% CI 0.29-0.87; and &gt;ten days: adjusted rate 59.3%, OR 0.49, 95% CI 0.31-0.81) was associated with lower risk of mortality compared with VA-ECMO lasting &lt;= three days (adjusted rate 78.3%). Patients requiring VA-ECMO therapy for eight-ten days (OR 1.96, 95% CI 1.15-3.33) and &gt;10 days (OR 1.85, 95% CI 1.14-3.02) had significantly greater mortality compared with those on VA-ECMO for 4 to 7 days. Conclusions: PCS patients weaned from VA-ECMO after four-seven days of support had significantly less mortality compared with those with shorter or longer mechanical support. (C) 2020 Elsevier Inc. All rights reserved.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of cardiothoracic and vascular anesthesia

ISSN

1053-0770

e-ISSN

—

Svazek periodika

35

Číslo periodika v rámci svazku

9

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

7

Strana od-do

2662-2668

Kód UT WoS článku

000680065100017

EID výsledku v databázi Scopus

2-s2.0-85097112241