PMID- 34238331
OWN - NLM
STAT- MEDLINE
DCOM- 20210721
LR  - 20210721
IS  - 1757-7241 (Electronic)
IS  - 1757-7241 (Linking)
VI  - 29
IP  - 1
DP  - 2021 Jul 8
TI  - Effect of arterial oxygen partial pressure inflection point on Venoarterial 
      extracorporeal membrane oxygenation for emergency cardiac support.
PG  - 90
LID - 10.1186/s13049-021-00902-5 [doi]
LID - 90
AB  - BACKGROUND: Temporary circulatory support is a bridge between acute circulatory 
      failure and definitive treatment or recovery. Currently, venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) is considered to be one of the 
      effective circulatory support methods, although cardiac function monitoring 
      during the treatment still needs further investigation. Inflection point of 
      arterial oxygen partial pressure (IPPaO2) may occur at an early stage in part of 
      patients with a good prognosis after VA-ECMO treatment, and the relationship 
      between time of IPPaO2 (tIPPaO2) and recovery of cardiac function or prognosis 
      remains unclear. METHODS: To investigate this relationship, we retrospectively 
      analyzed the clinical data of 71 patients with different conditions after 
      treatment with VA-ECMO in the emergency center of Jiangsu Province Hospital 
      between May 2015 and July 2020. Spearman's correlation analysis was used for the 
      correlation between tIPPaO(2) and quantitative data, and ROC curve for the 
      predictive effect of tIPPaO(2) on the 28-day mortality. RESULTS: Thirty-five 
      patients were admitted because of refractory cardiogenic shock (26 of 35 
      survived) and the remaining 36 patients due to cardiac arrest (13 of 36 
      survived). The overall survival rate was 54.9% (39 of 71 survived). Acute 
      physiology and chronic health evaluation II, ECMO time, tIPPaO2, continuous renal 
      replacement therapy time, mechanical ventilation time, and bleeding complications 
      in the survival group were lower than those in the non-survival group, with 
      length of stay, intensive care unit stay, and platelet levels were being higher. 
      The tIPPaO(2) was negatively correlated with ejection fraction, and the shorter 
      tIPPaO2 resulted in a higher 28-day survival probability, higher predictive value 
      for acute myocardial infarction and fulminant myocarditis. CONCLUSIONS: 
      Therefore, tIPPaO2 could be a reliable qualitative indicator of cardiac function 
      in patients treated with VA-ECMO, which can reveal appropriate timing for 
      adjusting VA-ECMO flow or weaning. TRIAL REGISTRATION: ChiCTR1900026105 .
FAU - Zhou, Hao
AU  - Zhou H
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Zhu, Yi
AU  - Zhu Y
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Zhang, Zhongman
AU  - Zhang Z
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Lv, Jinru
AU  - Lv J
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Li, Wei
AU  - Li W
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Hu, Deliang
AU  - Hu D
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China.
FAU - Chen, Xufeng
AU  - Chen X
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China. njmumy11@163.com.
FAU - Mei, Yong
AU  - Mei Y
AD  - Emergency Department, Jiangsu Province Hospital and Nanjing Medical University 
      First Affiliated Hospital, Nanjing, 210029, China. njmumy11@163.com.
LA  - eng
GR  - WSN-005/Six Talent Peaks Project in Jiangsu Province/
GR  - JSPH-511B-2018-9/511 Research Foundation of Jiangsu Province Hospital/
PT  - Journal Article
DEP - 20210708
PL  - England
TA  - Scand J Trauma Resusc Emerg Med
JT  - Scandinavian journal of trauma, resuscitation and emergency medicine
JID - 101477511
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - APACHE
MH  - Adult
MH  - Extracorporeal Membrane Oxygenation/*methods
MH  - Female
MH  - Heart Arrest/*therapy
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Oxygen/blood
MH  - Partial Pressure
MH  - Prognosis
MH  - Respiration, Artificial
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/*therapy
MH  - Survival Rate
PMC - PMC8268543
OTO - NOTNLM
OT  - Cardiac arrest
OT  - Cardiac function
OT  - Refractory cardiogenic shock
OT  - VA-ECMO
OT  - tIPPaO2
COIS- All authors declare no conflicts of interest.
EDAT- 2021/07/10 06:00
MHDA- 2021/07/22 06:00
PMCR- 2021/07/08
CRDT- 2021/07/09 05:46
PHST- 2021/01/20 00:00 [received]
PHST- 2021/06/11 00:00 [accepted]
PHST- 2021/07/09 05:46 [entrez]
PHST- 2021/07/10 06:00 [pubmed]
PHST- 2021/07/22 06:00 [medline]
PHST- 2021/07/08 00:00 [pmc-release]
AID - 10.1186/s13049-021-00902-5 [pii]
AID - 902 [pii]
AID - 10.1186/s13049-021-00902-5 [doi]
PST - epublish
SO  - Scand J Trauma Resusc Emerg Med. 2021 Jul 8;29(1):90. doi: 
      10.1186/s13049-021-00902-5.