Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019
Introduction: Extracorporeal membrane oxygenation (ECMO) is an imperative short-term cardiopulmonary support device now. We aimed to provide a single-center experience of veno-arterial (V-A) ECMO management and identify the risk factors of in-hospital mortality. Methods: We conducted a retrospective...
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| Veröffentlicht in: | Perfusion 2022-04, Vol.37 (3), p.235-241 |
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| creator | Gao, Sizhe Liu, Gang Yan, Shujie Lou, Song Gao, Guodong Hu, Qiang Zhang, Qiaoni Qi, Jiachen Yan, Weidong Wang, Qian Wang, Jian Ji, Bingyang |
| description | Introduction:
Extracorporeal membrane oxygenation (ECMO) is an imperative short-term cardiopulmonary support device now. We aimed to provide a single-center experience of veno-arterial (V-A) ECMO management and identify the risk factors of in-hospital mortality.
Methods:
We conducted a retrospective review of adult patients who received V-A ECMO between 2009 and 2019 in a cardiovascular disease center. The risk factor analysis of in-hospital mortality was conducted.
Results:
The study reviewed 236 patients, with an overall survival rate of 68.2%. The survivors’ blood lactate concentration is significantly lower than non-survivors [7.4 (7.8) vs 11.1 (9.7), p = 0.002]. Patients who received heart transplantation were with higher in-hospital survival rate. Survivors developed less hepatic dysfunction, acute kidney injury and myocardial damage [23 (14.3%) vs 19 (25.3%), p = 0.039; 81 (50.3%) vs 51 (68%), p = 0.011; 24 (14.9%) vs 22 (29.3%), p = 0.009, respectively], with higher rate of continuous renal replacement therapy (CRRT) [56 (34.8%) vs 53 (70.7%), p |
| doi_str_mv | 10.1177/0267659121993365 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2490120841</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0267659121993365</sage_id><sourcerecordid>2490120841</sourcerecordid><originalsourceid>FETCH-LOGICAL-c435t-4ec3ff4a0b020e02f33ceccfc6e99188b12c20a78987e348fe09a0e5688f716c3</originalsourceid><addsrcrecordid>eNp1kcFrFTEQh4Mo9rV69yQBL15WZ5JsNjlKqVYo9KLgbZmXNylbdjfPZLe0_vXm8apCwdMwzDffJPyEeIPwAbHrPoKynW09KvRea9s-Exs0Xdcg4o_nYnMYN4f5iTgt5RYAjDH6pTjRunXOWtyIX9frEtLERcacJkm7dVzkHc-pobxwHmiUfL9kCinvU-baTjxtM80s0_3DDc-0DGmWwyxJBsq7Id1RCetIWe6GwlRYBp6r6ehXAF4uqVb0r8SLSGPh14_1THz_fPHt_LK5uv7y9fzTVROMbpfGcNAxGoItKGBQUevAIcRg2Xt0bosqKKDOedexNi4yeAJurXOxQxv0mXh_9O5z-rlyWfppKIHHsX4iraVXxgMqcAYr-u4JepvWPNfX9cq2qlWojK0UHKmQUymZY7_Pw0T5oUfoD7n0T3OpK28fxet24t3fhT9BVKA5AoVu-N_V_wp_A0fQlQE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2652521246</pqid></control><display><type>article</type><title>Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Gao, Sizhe ; Liu, Gang ; Yan, Shujie ; Lou, Song ; Gao, Guodong ; Hu, Qiang ; Zhang, Qiaoni ; Qi, Jiachen ; Yan, Weidong ; Wang, Qian ; Wang, Jian ; Ji, Bingyang</creator><creatorcontrib>Gao, Sizhe ; Liu, Gang ; Yan, Shujie ; Lou, Song ; Gao, Guodong ; Hu, Qiang ; Zhang, Qiaoni ; Qi, Jiachen ; Yan, Weidong ; Wang, Qian ; Wang, Jian ; Ji, Bingyang</creatorcontrib><description>Introduction:
Extracorporeal membrane oxygenation (ECMO) is an imperative short-term cardiopulmonary support device now. We aimed to provide a single-center experience of veno-arterial (V-A) ECMO management and identify the risk factors of in-hospital mortality.
Methods:
We conducted a retrospective review of adult patients who received V-A ECMO between 2009 and 2019 in a cardiovascular disease center. The risk factor analysis of in-hospital mortality was conducted.
Results:
The study reviewed 236 patients, with an overall survival rate of 68.2%. The survivors’ blood lactate concentration is significantly lower than non-survivors [7.4 (7.8) vs 11.1 (9.7), p = 0.002]. Patients who received heart transplantation were with higher in-hospital survival rate. Survivors developed less hepatic dysfunction, acute kidney injury and myocardial damage [23 (14.3%) vs 19 (25.3%), p = 0.039; 81 (50.3%) vs 51 (68%), p = 0.011; 24 (14.9%) vs 22 (29.3%), p = 0.009, respectively], with higher rate of continuous renal replacement therapy (CRRT) [56 (34.8%) vs 53 (70.7%), p < 0.001]. Fewer survivors’ 24 hours and total chest drainage was over 1000 mL, and the rate of re-exploration as well as red blood cell and platelet transfusion were lower in survivors. In multivariate analysis, female, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and 24 hours chest drainage ⩾ 1000 mL were risk factors of early mortality.
Conclusions:
By providing a general description of V-A ECMO practice at a single-center in China. Post-heart transplant graft failure was associated with numerically, the greatest survival in our practice. Furthermore, female sex, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and high blood loss in chest drains are predictors of mortality in patients who undergo V-A ECMO.</description><identifier>ISSN: 0267-6591</identifier><identifier>EISSN: 1477-111X</identifier><identifier>DOI: 10.1177/0267659121993365</identifier><identifier>PMID: 33588661</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Blood ; Blood levels ; Blood transfusion ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - etiology ; Chest ; Erythrocytes ; Extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - adverse effects ; Factor analysis ; Female ; Females ; Graft rejection ; Grafts ; Health risks ; Heart diseases ; Heart transplantation ; Hospital Mortality ; Humans ; Hyperlipidemia ; Lactic Acid ; Male ; Membranes ; Mortality ; Multivariate analysis ; Oxygenation ; Patients ; Postoperative Complications - etiology ; Retrospective Studies ; Risk analysis ; Risk factors ; Risk management ; Shock, Cardiogenic - therapy ; Surgical drains ; Survival ; Transfusion ; Transplantation ; Transplants & implants ; Wound drainage</subject><ispartof>Perfusion, 2022-04, Vol.37 (3), p.235-241</ispartof><rights>The Author(s) 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-4ec3ff4a0b020e02f33ceccfc6e99188b12c20a78987e348fe09a0e5688f716c3</citedby><cites>FETCH-LOGICAL-c435t-4ec3ff4a0b020e02f33ceccfc6e99188b12c20a78987e348fe09a0e5688f716c3</cites><orcidid>0000-0003-0595-5044 ; 0000-0002-3753-9179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0267659121993365$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0267659121993365$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33588661$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gao, Sizhe</creatorcontrib><creatorcontrib>Liu, Gang</creatorcontrib><creatorcontrib>Yan, Shujie</creatorcontrib><creatorcontrib>Lou, Song</creatorcontrib><creatorcontrib>Gao, Guodong</creatorcontrib><creatorcontrib>Hu, Qiang</creatorcontrib><creatorcontrib>Zhang, Qiaoni</creatorcontrib><creatorcontrib>Qi, Jiachen</creatorcontrib><creatorcontrib>Yan, Weidong</creatorcontrib><creatorcontrib>Wang, Qian</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Ji, Bingyang</creatorcontrib><title>Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019</title><title>Perfusion</title><addtitle>Perfusion</addtitle><description>Introduction:
Extracorporeal membrane oxygenation (ECMO) is an imperative short-term cardiopulmonary support device now. We aimed to provide a single-center experience of veno-arterial (V-A) ECMO management and identify the risk factors of in-hospital mortality.
Methods:
We conducted a retrospective review of adult patients who received V-A ECMO between 2009 and 2019 in a cardiovascular disease center. The risk factor analysis of in-hospital mortality was conducted.
Results:
The study reviewed 236 patients, with an overall survival rate of 68.2%. The survivors’ blood lactate concentration is significantly lower than non-survivors [7.4 (7.8) vs 11.1 (9.7), p = 0.002]. Patients who received heart transplantation were with higher in-hospital survival rate. Survivors developed less hepatic dysfunction, acute kidney injury and myocardial damage [23 (14.3%) vs 19 (25.3%), p = 0.039; 81 (50.3%) vs 51 (68%), p = 0.011; 24 (14.9%) vs 22 (29.3%), p = 0.009, respectively], with higher rate of continuous renal replacement therapy (CRRT) [56 (34.8%) vs 53 (70.7%), p < 0.001]. Fewer survivors’ 24 hours and total chest drainage was over 1000 mL, and the rate of re-exploration as well as red blood cell and platelet transfusion were lower in survivors. In multivariate analysis, female, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and 24 hours chest drainage ⩾ 1000 mL were risk factors of early mortality.
Conclusions:
By providing a general description of V-A ECMO practice at a single-center in China. Post-heart transplant graft failure was associated with numerically, the greatest survival in our practice. Furthermore, female sex, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and high blood loss in chest drains are predictors of mortality in patients who undergo V-A ECMO.</description><subject>Adult</subject><subject>Blood</subject><subject>Blood levels</subject><subject>Blood transfusion</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Chest</subject><subject>Erythrocytes</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - adverse effects</subject><subject>Factor analysis</subject><subject>Female</subject><subject>Females</subject><subject>Graft rejection</subject><subject>Grafts</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Heart transplantation</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hyperlipidemia</subject><subject>Lactic Acid</subject><subject>Male</subject><subject>Membranes</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Oxygenation</subject><subject>Patients</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Risk management</subject><subject>Shock, Cardiogenic - therapy</subject><subject>Surgical drains</subject><subject>Survival</subject><subject>Transfusion</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Wound drainage</subject><issn>0267-6591</issn><issn>1477-111X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFrFTEQh4Mo9rV69yQBL15WZ5JsNjlKqVYo9KLgbZmXNylbdjfPZLe0_vXm8apCwdMwzDffJPyEeIPwAbHrPoKynW09KvRea9s-Exs0Xdcg4o_nYnMYN4f5iTgt5RYAjDH6pTjRunXOWtyIX9frEtLERcacJkm7dVzkHc-pobxwHmiUfL9kCinvU-baTjxtM80s0_3DDc-0DGmWwyxJBsq7Id1RCetIWe6GwlRYBp6r6ehXAF4uqVb0r8SLSGPh14_1THz_fPHt_LK5uv7y9fzTVROMbpfGcNAxGoItKGBQUevAIcRg2Xt0bosqKKDOedexNi4yeAJurXOxQxv0mXh_9O5z-rlyWfppKIHHsX4iraVXxgMqcAYr-u4JepvWPNfX9cq2qlWojK0UHKmQUymZY7_Pw0T5oUfoD7n0T3OpK28fxet24t3fhT9BVKA5AoVu-N_V_wp_A0fQlQE</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Gao, Sizhe</creator><creator>Liu, Gang</creator><creator>Yan, Shujie</creator><creator>Lou, Song</creator><creator>Gao, Guodong</creator><creator>Hu, Qiang</creator><creator>Zhang, Qiaoni</creator><creator>Qi, Jiachen</creator><creator>Yan, Weidong</creator><creator>Wang, Qian</creator><creator>Wang, Jian</creator><creator>Ji, Bingyang</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0595-5044</orcidid><orcidid>https://orcid.org/0000-0002-3753-9179</orcidid></search><sort><creationdate>20220401</creationdate><title>Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019</title><author>Gao, Sizhe ; Liu, Gang ; Yan, Shujie ; Lou, Song ; Gao, Guodong ; Hu, Qiang ; Zhang, Qiaoni ; Qi, Jiachen ; Yan, Weidong ; Wang, Qian ; Wang, Jian ; Ji, Bingyang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-4ec3ff4a0b020e02f33ceccfc6e99188b12c20a78987e348fe09a0e5688f716c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Blood</topic><topic>Blood levels</topic><topic>Blood transfusion</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Chest</topic><topic>Erythrocytes</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Extracorporeal Membrane Oxygenation - adverse effects</topic><topic>Factor analysis</topic><topic>Female</topic><topic>Females</topic><topic>Graft rejection</topic><topic>Grafts</topic><topic>Health risks</topic><topic>Heart diseases</topic><topic>Heart transplantation</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hyperlipidemia</topic><topic>Lactic Acid</topic><topic>Male</topic><topic>Membranes</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Oxygenation</topic><topic>Patients</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Risk management</topic><topic>Shock, Cardiogenic - therapy</topic><topic>Surgical drains</topic><topic>Survival</topic><topic>Transfusion</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Wound drainage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gao, Sizhe</creatorcontrib><creatorcontrib>Liu, Gang</creatorcontrib><creatorcontrib>Yan, Shujie</creatorcontrib><creatorcontrib>Lou, Song</creatorcontrib><creatorcontrib>Gao, Guodong</creatorcontrib><creatorcontrib>Hu, Qiang</creatorcontrib><creatorcontrib>Zhang, Qiaoni</creatorcontrib><creatorcontrib>Qi, Jiachen</creatorcontrib><creatorcontrib>Yan, Weidong</creatorcontrib><creatorcontrib>Wang, Qian</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Ji, Bingyang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Perfusion</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Sizhe</au><au>Liu, Gang</au><au>Yan, Shujie</au><au>Lou, Song</au><au>Gao, Guodong</au><au>Hu, Qiang</au><au>Zhang, Qiaoni</au><au>Qi, Jiachen</au><au>Yan, Weidong</au><au>Wang, Qian</au><au>Wang, Jian</au><au>Ji, Bingyang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019</atitle><jtitle>Perfusion</jtitle><addtitle>Perfusion</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>37</volume><issue>3</issue><spage>235</spage><epage>241</epage><pages>235-241</pages><issn>0267-6591</issn><eissn>1477-111X</eissn><abstract>Introduction:
Extracorporeal membrane oxygenation (ECMO) is an imperative short-term cardiopulmonary support device now. We aimed to provide a single-center experience of veno-arterial (V-A) ECMO management and identify the risk factors of in-hospital mortality.
Methods:
We conducted a retrospective review of adult patients who received V-A ECMO between 2009 and 2019 in a cardiovascular disease center. The risk factor analysis of in-hospital mortality was conducted.
Results:
The study reviewed 236 patients, with an overall survival rate of 68.2%. The survivors’ blood lactate concentration is significantly lower than non-survivors [7.4 (7.8) vs 11.1 (9.7), p = 0.002]. Patients who received heart transplantation were with higher in-hospital survival rate. Survivors developed less hepatic dysfunction, acute kidney injury and myocardial damage [23 (14.3%) vs 19 (25.3%), p = 0.039; 81 (50.3%) vs 51 (68%), p = 0.011; 24 (14.9%) vs 22 (29.3%), p = 0.009, respectively], with higher rate of continuous renal replacement therapy (CRRT) [56 (34.8%) vs 53 (70.7%), p < 0.001]. Fewer survivors’ 24 hours and total chest drainage was over 1000 mL, and the rate of re-exploration as well as red blood cell and platelet transfusion were lower in survivors. In multivariate analysis, female, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and 24 hours chest drainage ⩾ 1000 mL were risk factors of early mortality.
Conclusions:
By providing a general description of V-A ECMO practice at a single-center in China. Post-heart transplant graft failure was associated with numerically, the greatest survival in our practice. Furthermore, female sex, pre-ECMO blood lactate concentration, hyperlipidemia, CRRT, and high blood loss in chest drains are predictors of mortality in patients who undergo V-A ECMO.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>33588661</pmid><doi>10.1177/0267659121993365</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0595-5044</orcidid><orcidid>https://orcid.org/0000-0002-3753-9179</orcidid></addata></record> |
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| subjects | Adult Blood Blood levels Blood transfusion Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - etiology Chest Erythrocytes Extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - adverse effects Factor analysis Female Females Graft rejection Grafts Health risks Heart diseases Heart transplantation Hospital Mortality Humans Hyperlipidemia Lactic Acid Male Membranes Mortality Multivariate analysis Oxygenation Patients Postoperative Complications - etiology Retrospective Studies Risk analysis Risk factors Risk management Shock, Cardiogenic - therapy Surgical drains Survival Transfusion Transplantation Transplants & implants Wound drainage |
| title | Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019 |
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