PMID- 34759121
OWN - NLM
STAT- MEDLINE
DCOM- 20220414
LR  - 20220414
IS  - 1347-4820 (Electronic)
IS  - 1346-9843 (Linking)
VI  - 86
IP  - 4
DP  - 2022 Mar 25
TI  - Vasoactive-Inotropic Score as a Determinant of Timely Initiation of Venoarterial 
      Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock.
PG  - 687-694
LID - 10.1253/circj.CJ-21-0614 [doi]
AB  - BACKGROUND: The predictive role of the vasoactive-inotropic score (VIS) for 
      clinical outcomes after venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) in patients with cardiogenic shock is not well known. This study 
      investigated the predictive value of VIS on in-hospital outcomes and the 
      determination of optimal timing for the initiation of 
      VA-ECMO.Methods and Results:Overall, 160 patients with cardiogenic shock 
      requiring VA-ECMO who were treated between December 2012 and August 2018 were 
      analyzed. The in-hospital outcomes according to VIS were compared. Pre-ECMO VIS 
      had an area under the receiver-operating characteristic curve (AUC) of 0.60 
      (P=0.03) for the prediction of in-hospital death. When the patients were divided 
      into the high (>/=32) and low (<32) VIS groups, the high VIS group had a higher 
      rate of in-hospital death (P=0.002) and a lower rate of ECMO weaning (P=0.004). 
      The difference in in-hospital death according to VIS was significant only in 
      patients with a cardiogenic shock of non-ischemic etiology (P=0.01). 
      Extracorporeal cardiopulmonary resuscitation (hazard ratio [HR], 1.99), age (HR, 
      1.02), pre-ECMO lactate (HR, 1.06), and VIS >/=32 (HR, 2.46) were independently 
      predictive of in-hospital death. CONCLUSIONS: Among patients with cardiogenic 
      shock requiring VA-ECMO, the initiation of VA-ECMO before reaching high VIS (>/=32) 
      showed better in-hospital outcomes, suggesting that VIS may be a potential marker 
      for determining the initiation of hemodynamic support with VA-ECMO.
FAU - Hyun, Junho
AU  - Hyun J
AD  - Division of Cardiology, Department of Internal Medicine, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Kim, Ah-Ram
AU  - Kim AR
AD  - Division of Cardiology, Department of Internal Medicine, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Lee, Sang Eun
AU  - Lee SE
AD  - Division of Cardiology, Department of Internal Medicine, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Hong, Jung Ae
AU  - Hong JA
AD  - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Kang, Pil Je
AU  - Kang PJ
AD  - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Jung, Sung-Ho
AU  - Jung SH
AD  - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, 
      University of Ulsan College of Medicine.
FAU - Kim, Min-Seok
AU  - Kim MS
AD  - Division of Cardiology, Department of Internal Medicine, Asan Medical Center, 
      University of Ulsan College of Medicine.
LA  - eng
PT  - Journal Article
DEP - 20211109
PL  - Japan
TA  - Circ J
JT  - Circulation journal : official journal of the Japanese Circulation Society
JID - 101137683
SB  - IM
CIN - Circ J. 2022 Mar 25;86(4):695-698. PMID: 34911898
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Hospital Mortality
MH  - Humans
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/therapy
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Extracorporeal membrane oxygenation
OT  - In-hospital mortality
OT  - Vasoactive-inotropic score
EDAT- 2021/11/12 06:00
MHDA- 2022/04/15 06:00
CRDT- 2021/11/11 06:36
PHST- 2021/11/12 06:00 [pubmed]
PHST- 2022/04/15 06:00 [medline]
PHST- 2021/11/11 06:36 [entrez]
AID - 10.1253/circj.CJ-21-0614 [doi]
PST - ppublish
SO  - Circ J. 2022 Mar 25;86(4):687-694. doi: 10.1253/circj.CJ-21-0614. Epub 2021 Nov 
      9.