PMID- 28422817
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20220409
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 63
IP  - 3
DP  - 2017 May/Jun
TI  - Incidence and Implications of Left Ventricular Distention During Venoarterial 
      Extracorporeal Membrane Oxygenation Support.
PG  - 257-265
LID - 10.1097/MAT.0000000000000553 [doi]
AB  - Left ventricular distention (LVD) during venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) support is increasingly recognized but seldom reported in 
      the literature. The current study defined LVD as not present (LVD-); subclinical 
      (LVD+, evidence of pulmonary edema on chest radiograph AND pulmonary artery 
      diastolic blood pressure greater than 25 mm Hg within the first 2 hours of 
      intensive care unit admission); or clinical (LVD++, need for decompression of the 
      left ventricle immediately following VA-ECMO initiation). Among 226 VA-ECMO 
      device runs, 121 had sufficient data to define LVD retrospectively. Nine patients 
      (7%) developed LVD++ requiring immediate decompression, and 27 patients (22%) met 
      the definition of LVD+. Survival to discharge was similar among groups (LVD++: 
      44%, LVD+: 41%, LVD-: 44%). However, myocardial recovery appeared inversely 
      related to the degree of LVD (LVD++: 11%, LVD+: 26%, LVD-: 40%). When death or 
      transition to device was considered as a composite outcome, event-free survival 
      was diminished in LVD++ and LVD+ patients compared with LVD-. Multivariable 
      analysis identified cannulation of VA-ECMO during extracorporeal cardiopulmonary 
      resuscitation (ECPR) as a risk factor for decompression (odds ratio [OR]: 3.64, 
      confidence interval [CI]: 1.21-10.98; p = 0.022). Using a novel definition of 
      LVD, the severity LVD was inversely related to the likelihood of myocardial 
      recovery. Survival did not differ between groups. Extracorporeal cardiopulmonary 
      resuscitation was associated with need for mechanical intervention.
FAU - Truby, Lauren K
AU  - Truby LK
AD  - From the *Department of Medicine, Columbia University Medical Center, New York, 
      New York; daggerDepartment of Surgery, Columbia University Medical Center, New York, 
      New York; and double daggerMailman School of Public Health, Columbia University Medical 
      Center, New York, New York.
FAU - Takeda, Koji
AU  - Takeda K
FAU - Mauro, Christine
AU  - Mauro C
FAU - Yuzefpolskaya, Melana
AU  - Yuzefpolskaya M
FAU - Garan, Arthur R
AU  - Garan AR
FAU - Kirtane, Ajay J
AU  - Kirtane AJ
FAU - Topkara, Veli K
AU  - Topkara VK
FAU - Abrams, Darryl
AU  - Abrams D
FAU - Brodie, Daniel
AU  - Brodie D
FAU - Colombo, Paolo C
AU  - Colombo PC
FAU - Naka, Yoshifumi
AU  - Naka Y
FAU - Takayama, Hiroo
AU  - Takayama H
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
CIN - J Thorac Dis. 2017 Nov;9(11):4149-4151. PMID: 29268456
CIN - J Thorac Dis. 2017 Dec;9(12 ):4915-4918. PMID: 29312691
CIN - J Thorac Dis. 2017 Dec;9(12 ):4919-4921. PMID: 29312692
MH  - Adult
MH  - Aged
MH  - Cardiopulmonary Resuscitation
MH  - Decompression, Surgical
MH  - Extracorporeal Membrane Oxygenation/*adverse effects
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Ventricular Function, Left
EDAT- 2017/04/20 06:00
MHDA- 2018/01/05 06:00
CRDT- 2017/04/20 06:00
PHST- 2017/04/20 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
PHST- 2017/04/20 06:00 [entrez]
AID - 10.1097/MAT.0000000000000553 [doi]
PST - ppublish
SO  - ASAIO J. 2017 May/Jun;63(3):257-265. doi: 10.1097/MAT.0000000000000553.