PMID- 26611934
OWN - NLM
STAT- MEDLINE
DCOM- 20170623
LR  - 20181202
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 68
IP  - 5
DP  - 2016 Nov
TI  - Prognostic effect of estimated glomerular filtration rate in patients with 
      cardiogenic shock or cardiac arrest undergoing percutaneous veno-arterial 
      extracorporeal membrane oxygenation.
PG  - 439-446
LID - S0914-5087(15)00356-1 [pii]
LID - 10.1016/j.jjcc.2015.10.014 [doi]
AB  - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) can 
      improve survival in patients with cardiogenic shock or cardiac arrest. We 
      investigated the association between initial renal function and clinical outcome 
      in patients undergoing VA-ECMO for cardiogenic shock and cardiac arrest. METHODS: 
      This was a single-center, retrospective cohort study of 287 patients who 
      underwent ECMO at our hospital from January 2005 to December 2014. We excluded 70 
      patients with non-cardiogenic events. The remaining 217 patients were divided 
      into 2 groups according to initial estimated glomerular filtration rate (eGFR): 
      Initial high eGFR (non-renal failure: non-RF) group: eGFR>/=60ml/min/1.73m(2) 
      (n=73) and initial low eGFR (RF) group: eGFR<60ml/min/1.73m(2) (n=144). Clinical 
      outcome was defined as all-cause death at 30 days after extracorporeal life 
      support. RESULTS: VA-ECMO was begun in 87% of patients for cardiac arrest. The 
      non-RF group was significantly younger (51.6 vs. 62.6 years), had lower body mass 
      index (22.8 vs. 24.7kg/m(2)), lower blood urea nitrogen (14.4 vs. 23.9mg/dl), and 
      lower K (4.0 vs. 4.5mEq/l, all p<0.05) than the RF group. Incidence of all-cause 
      death at 30 days was significantly lower in the non-RF than RF group (49% vs. 
      76%, p<0.0001). Initial low eGFR was an independent predictor of mortality after 
      adjustment for multiple cofounders (OR: 4.08, 95% CI: 1.77-9.42, p<0.001). 
      Kaplan-Meier curve showed better outcome in the non-RF versus RF group 
      (p=0.0009). CONCLUSION: An initial low eGFR may predict worse clinical outcome in 
      patients undergoing VA-ECMO for cardiogenic shock and cardiac arrest.
CI  - Copyright (c) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Kuroki, Norihiro
AU  - Kuroki N
AD  - Department of Cardiology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
FAU - Abe, Daisuke
AU  - Abe D
AD  - Department of Cardiology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. 
      Electronic address: daisuke-a@mtg.biglobe.ne.jp.
FAU - Iwama, Toru
AU  - Iwama T
AD  - Department of Cardiology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
FAU - Sugiyama, Kazuhiro
AU  - Sugiyama K
AD  - Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, 
      Japan.
FAU - Akashi, Akiko
AU  - Akashi A
AD  - Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, 
      Japan.
FAU - Hamabe, Yuichi
AU  - Hamabe Y
AD  - Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, 
      Japan.
FAU - Aonuma, Kazutaka
AU  - Aonuma K
AD  - Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, 
      Japan.
FAU - Sato, Akira
AU  - Sato A
AD  - Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20151121
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Cohort Studies
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Heart Arrest/*mortality/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/*mortality/therapy
OTO - NOTNLM
OT  - Cardiopulmonary bypass
OT  - Cardiopulmonary resuscitation
OT  - Chronic kidney disease
OT  - Estimated glomerular filtration rate
OT  - Extracorporeal membrane oxygenation
OT  - Shock
EDAT- 2016/10/19 06:00
MHDA- 2017/06/24 06:00
CRDT- 2015/11/28 06:00
PHST- 2015/08/18 00:00 [received]
PHST- 2015/10/07 00:00 [revised]
PHST- 2015/10/15 00:00 [accepted]
PHST- 2016/10/19 06:00 [pubmed]
PHST- 2017/06/24 06:00 [medline]
PHST- 2015/11/28 06:00 [entrez]
AID - S0914-5087(15)00356-1 [pii]
AID - 10.1016/j.jjcc.2015.10.014 [doi]
PST - ppublish
SO  - J Cardiol. 2016 Nov;68(5):439-446. doi: 10.1016/j.jjcc.2015.10.014. Epub 2015 Nov 
      21.