BACKGROUND: It is not easy to predict the prognosis of patients receiving extracorporeal life support (ECLS) because of the highly variable situation around its implementation. We evaluated the role of pulse pressure (PP), which is available on real-time basis, as a hemodynamic prognostic marker during ECLS. METHODS: From January 2009 to August 2011, data from 69 patients who were treated with ECLS for at least 6h in a single center for any cause was collected. We calculated the mean PP over the first 6h after ECLS implantation and examined if there was any correlation between mean PP and the study endpoints, in-hospital death and ECLS weaning failure. RESULTS: The causes of ECLS were of cardiac origin in 36 patients (52%). 27 patients (39.1%) weaned off ELCS and 13 patients (18.8%) survived to discharge. In Cox regression analysis (with age, Killip class ≥3, ECLS implementation during cardiopulmonary resuscitation (CPR), CPR duration, out-of-hospital arrest, initial laboratory results including blood gas analysis, initial systolic blood pressure (SBP), mean SBP over the first 6h after ECLS implantation, mean PP over the first 6h after ECLS implantation as independent variables), mean PP over the first 6h after ECLS implantation (hazard ratio [95% confidence interval]=0.96[0.94-0.98], P<0.001) and out-of-hospital arrest (HR[95%CI]=2.04[1.14-3.62], P=0.02) were independent predictors of in-hospital mortality and mean PP over the first 6h after ECLS implantation (HR[95% CI]=0.95[0.93-0.98], P<0.001) was the sole independent predictor of weaning failure. CONCLUSION: Higher mean PP over the initial 6h after ECLS implementation independently predicted successful weaning and survival. Our findings may help better predict and analyze prognosis in patients receiving ECLS.
BACKGROUND: It is not easy to predict the prognosis of patients receiving extracorporeal life support (ECLS) because of the highly variable situation around its implementation. We evaluated the role of pulse pressure (PP), which is available on real-time basis, as a hemodynamic prognostic marker during ECLS. METHODS: From January 2009 to August 2011, data from 69 patients who were treated with ECLS for at least 6h in a single center for any cause was collected. We calculated the mean PP over the first 6h after ECLS implantation and examined if there was any correlation between mean PP and the study endpoints, in-hospital death and ECLS weaning failure. RESULTS: The causes of ECLS were of cardiac origin in 36 patients (52%). 27 patients (39.1%) weaned off ELCS and 13 patients (18.8%) survived to discharge. In Cox regression analysis (with age, Killip class ≥3, ECLS implementation during cardiopulmonary resuscitation (CPR), CPR duration, out-of-hospital arrest, initial laboratory results including blood gas analysis, initial systolic blood pressure (SBP), mean SBP over the first 6h after ECLS implantation, mean PP over the first 6h after ECLS implantation as independent variables), mean PP over the first 6h after ECLS implantation (hazard ratio [95% confidence interval]=0.96[0.94-0.98], P<0.001) and out-of-hospital arrest (HR[95%CI]=2.04[1.14-3.62], P=0.02) were independent predictors of in-hospital mortality and mean PP over the first 6h after ECLS implantation (HR[95% CI]=0.95[0.93-0.98], P<0.001) was the sole independent predictor of weaning failure. CONCLUSION: Higher mean PP over the initial 6h after ECLS implementation independently predicted successful weaning and survival. Our findings may help better predict and analyze prognosis in patients receiving ECLS.
Authors: Aniket S Rali; Sagar Ranka; Amy Butcher; Zubair Shah; Joseph E Tonna; Marc M Anders; Marshal D Brinkley; Hasan Siddiqi; Lynn Punnoose; Mark Wigger; Suzanne B Sacks; Dawn Pedrotty; Henry Ooi; Matthew D Bacchetta; Jordan Hoffman; William McMaster; Keki Balsara; Ashish S Shah; Jonathan N Menachem; Kelly H Schlendorf; JoAnn Lindenfeld; Sandip K Zalawadiya Journal: JACC Heart Fail Date: 2022-06 Impact factor: 12.544
Authors: Enzo Lüsebrink; Christopher Stremmel; Konstantin Stark; Dominik Joskowiak; Thomas Czermak; Frank Born; Danny Kupka; Clemens Scherer; Mathias Orban; Tobias Petzold; Patrick von Samson-Himmelstjerna; Stefan Kääb; Christian Hagl; Steffen Massberg; Sven Peterss; Martin Orban Journal: J Clin Med Date: 2020-04-02 Impact factor: 4.241
Authors: Marc Mourad; Jacob Eliet; Norddine Zeroual; Marine Saour; Pierre Sentenac; Federico Manna; Nicolas Molinari; Thomas Gandet; Pascal H Colson; Philippe Gaudard Journal: Crit Care Date: 2020-09-22 Impact factor: 9.097