PMID- 27718412
OWN - NLM
STAT- MEDLINE
DCOM- 20170922
LR  - 20181202
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 37
DP  - 2017 Feb
TI  - Early fluid resuscitation and volume therapy in venoarterial extracorporeal 
      membrane oxygenation.
PG  - 130-135
LID - S0883-9441(16)30546-9 [pii]
LID - 10.1016/j.jcrc.2016.09.017 [doi]
AB  - PURPOSE: For circulatory support, venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) is dependent on sufficient venous drainage ensured by fluid 
      therapy. Volume overload however is linked to poor prognosis. This study 
      therefore evaluates volume therapy in VA-ECMO. MATERIAL AND METHODS: We report 
      data of a single center registry of all patients after VA-ECMO implantation 
      treated between 2010 and 2015. RESULTS: A total of 195 patients were included in 
      this registry with a medium age of 58.2 +/- 1.1 years, 71.8% were male. A positive 
      fluid balance was detected in 94.7% at day 1 (day 2: 93.7%, day 3: 92.6%). 
      Consistently, survivors had a lower fluid balance when compared to non-survivors 
      (P < .001). Three hours post-implantation, patients above the 75th percentile had 
      a hazard ratio of 6.03 when compared to average survival (P < .05). AUC at that 
      time point was 0.726 as calculated by ROC. Patients below the 50th percentile 
      (fluid balance below 8500 mL after 24 hours) had the best prognosis after VA-ECMO 
      implantation (P < .001). CONCLUSIONS: Higher fluid balance was consistently 
      linked to poor survival. We found no evidence to support a liberal fluid therapy 
      in VA-ECMO patients, especially not the early after implantation. With a 
      retrospective study, one cannot clarify if lower fluid balance might improve 
      outcomes or represents a prognostic marker.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Staudacher, Dawid L
AU  - Staudacher DL
AD  - Department of Cardiology and Angiology I, Heart Center Freiburg University, 
      Germany. Electronic address: dawid.staudacher@universitaets-herzzentrum.de.
FAU - Gold, Wolfgang
AU  - Gold W
AD  - Department of Cardiology and Angiology I, Heart Center Freiburg University, 
      Germany.
FAU - Biever, Paul M
AU  - Biever PM
AD  - Department of Cardiology and Angiology I, Heart Center Freiburg University, 
      Germany.
FAU - Bode, Christoph
AU  - Bode C
AD  - Department of Cardiology and Angiology I, Heart Center Freiburg University, 
      Germany.
FAU - Wengenmayer, Tobias
AU  - Wengenmayer T
AD  - Department of Cardiology and Angiology I, Heart Center Freiburg University, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20160927
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
SB  - IM
MH  - Critical Care
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - *Fluid Therapy
MH  - Germany
MH  - Heart Failure/mortality/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Registries
MH  - *Resuscitation
MH  - Retrospective Studies
MH  - Water-Electrolyte Balance
OTO - NOTNLM
OT  - Cardiopulmonary resuscitation
OT  - Critically Ill
OT  - Prognosis
OT  - Sepsis
OT  - Veno-arterial extracorporeal membrane oxygenation
OT  - Water-electrolyte balance
EDAT- 2016/10/09 06:00
MHDA- 2017/09/25 06:00
CRDT- 2016/10/09 06:00
PHST- 2016/06/27 00:00 [received]
PHST- 2016/08/26 00:00 [revised]
PHST- 2016/09/16 00:00 [accepted]
PHST- 2016/10/09 06:00 [pubmed]
PHST- 2017/09/25 06:00 [medline]
PHST- 2016/10/09 06:00 [entrez]
AID - S0883-9441(16)30546-9 [pii]
AID - 10.1016/j.jcrc.2016.09.017 [doi]
PST - ppublish
SO  - J Crit Care. 2017 Feb;37:130-135. doi: 10.1016/j.jcrc.2016.09.017. Epub 2016 Sep 
      27.