Patient Demographics and Extracorporeal Membranous Oxygenation (ECMO)-Related Complications Associated With Survival to Discharge or 30-Day Survival in Adult Patients Receiving Venoarterial (VA) and Venovenous (VV) ECMO in a Quaternary Care Urban Center
| Autor: | Nitish Gupta, Mudit Kaushal, Galina Leyvi, Jonathan D. Leff, Jay Im, William Jakobleff, Joseph Schwartz |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Multiple Organ Failure 030204 cardiovascular system & hematology Extracorporeal 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Hospitals Urban 030202 anesthesiology Medicine Humans Extracorporeal cardiopulmonary resuscitation Hospital Mortality Aged Retrospective Studies business.industry Cardiogenic shock Acute kidney injury Age Factors Retrospective cohort study Odds ratio Oxygenation Middle Aged medicine.disease Patient Discharge Survival Rate surgical procedures operative Anesthesiology and Pain Medicine Emergency medicine Female Hemofiltration Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 33(4) |
| ISSN: | 1532-8422 |
| Popis: | Objective Investigate how a multitude of patient demographics and extracorporeal membranous oxygenation (ECMO)-related complications affect 30-day survival or survival to discharge. Design Retrospective observational study. Setting Urban university hospital, quaternary care center. Participants Patients who underwent ECMO circulatory support from January 2012 to May 2016. Interventions Date-based data extraction, univariate and multivariate regression analysis. Measurements and Main Results The hospital database contained complete data for 235 adult patients who received venoarterial ECMO (74.04 %) and venovenous ECMO (25.96 %); 106 patients (45.11%) survived. The independent predictors significant in the odds of in-hospital mortality in a multiregression model were age (odds ratio [OR] = 1.028, p = 0.008), extracorporeal cardiopulmonary resuscitation (ECPR) after unsuccessful high-quality CPR (OR = 7.93, p =0.002), cardiogenic shock as the primary indication for circulatory support (OR = 2.58, p = 0.02), acute kidney injury (AKI) before ECMO initiation (OR = 7.53, p Conclusion The most significant findings of advancing age, time spent on ECMO, AKI, ECMO use in the setting of cardiogenic shock, ECPR, and limb ischemia as a complication of ECMO all independently increase the odds of in-hospital and 30-day mortality. To the best of the authors’ knowledge, this study is the first to demonstrate a significant relationship between limb ischemia and mortality. |
| Databáze: | OpenAIRE |
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