PMID- 36316178
OWN - NLM
STAT- MEDLINE
DCOM- 20221102
LR  - 20230129
IS  - 1937-710X (Electronic)
IS  - 1062-3264 (Linking)
VI  - 31
IP  - 6
DP  - 2022 Nov 1
TI  - Echocardiographic Prediction of Successful Weaning From Venoarterial 
      Extracorporeal Membrane Oxygenation.
PG  - 483-493
LID - 10.4037/ajcc2022588 [doi]
AB  - BACKGROUND: Weaning from venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) support fails in 30% to 70% of patients. OBJECTIVE: To explore the 
      utility of echocardiographic parameters in predicting successful disconnection 
      from VA-ECMO. METHODS: Patients receiving VA-ECMO in a referral hospital were 
      included. The relationships between echocardiographic parameters during the 
      weaning trial and weaning success (survival > 24 hours after VA-ECMO explant and 
      no death from cardiogenic shock, heart failure, or cardiac arrest during the 
      hospital stay) and survival were evaluated. RESULTS: Of 85 patients included, 61% 
      had successful weaning. Parameters significantly related to weaning success were 
      higher left ventricular ejection fraction (LVEF; 40% in patients with weaning 
      success vs 30% in patients with weaning failure, P = .01), left ventricular 
      outflow tract velocity time integral (15 cm vs 11 cm, P = .01), aortic valve 
      opening in every cycle (98% vs 91% of patients, P = .01), and normal qualitative 
      right ventricular function (60% vs 42% of patients, P = .02). The LVEF remained 
      as an independent predictor of weaning success (hazard ratio, 0.938; 95% CI, 
      0.888-0.991; P = .02). An LVEF >33.4% was the optimal cutoff value to 
      discriminate patients with successful weaning (area under the curve, 0.808; 
      sensitivity, 93%; specificity, 72%) and was related to higher survival at 
      discharge (60% vs 20%, P < .001). CONCLUSION: Among weaning trial 
      echocardiographic parameters, LVEF was the only independent predictor of 
      successful VA-ECMO weaning. An LVEF >33.4% was the optimal cutoff value to 
      discriminate patients with successful weaning and was related to final survival.
CI  - (c)2022 American Association of Critical-Care Nurses.
FAU - Alonso-Fernandez-Gatta, Marta
AU  - Alonso-Fernandez-Gatta M
AD  - Marta Alonso-Fernandez-Gatta is a cardiologist at University Hospital of 
      Salamanca-Instituto de Investigacion Biomedica de Salamanca (IBSAL), Salamanca, 
      Spain and takes part in the Centro de Investigacion en Red de Enfermedades Cardio 
      vasculares (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain.
FAU - Merchan-Gomez, Soraya
AU  - Merchan-Gomez S
AD  - Soraya Merchan-Gomez is a cardiologist at University Hospital of Salamanca-IBSAL 
      and takes part in CIBER-CV, Instituto de Salud Carlos III.
FAU - Gonzalez-Cebrian, Miryam
AU  - Gonzalez-Cebrian M
AD  - Miryam Gonzalez-Cebrian is a nursing supervisor, Cardiology Department, 
      University Hospital of Salamanca-IBSAL.
FAU - Diego-Nieto, Alejandro
AU  - Diego-Nieto A
AD  - Alejandro Diego-Nieto is a cardiologist at University Hospital of Salamanca-IBSAL 
      and takes part in CIBER-CV, Instituto de Salud Carlos III.
FAU - Gonzalez-Martin, Javier
AU  - Gonzalez-Martin J
AD  - Javier Gonzalez-Martin is a cardiologist, University Hospital of Salamanca-IBSAL.
FAU - Toranzo-Nieto, Ines
AU  - Toranzo-Nieto I
AD  - Ines Toranzo-Nieto is a cardiologist at University Hospital of Salamanca-IBSAL 
      and takes part in CIBER-CV, Instituto de Salud Carlos III.
FAU - Barrio, Alfredo
AU  - Barrio A
AD  - Alfredo Barrio is a cardiologist at University Hospital of Salamanca-IBSAL and 
      takes part in CIBER-CV, Instituto de Salud Carlos III.
FAU - Martin-Herrero, Francisco
AU  - Martin-Herrero F
AD  - Francisco Martin-Herrero is a cardiologist at University Hospital of 
      Salamanca-IBSAL and takes part in CIBER-CV, Instituto de Salud Carlos III.
FAU - Sanchez, Pedro L
AU  - Sanchez PL
AD  - Pedro L. Sanchez is head of the Cardiology Department, University Hospital of 
      Salamanca-IBSAL, and takes part in CIBER-CV, Instituto de Salud Carlos III.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Crit Care
JT  - American journal of critical care : an official publication, American Association 
      of Critical-Care Nurses
JID - 9211547
SB  - IM
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - Shock, Cardiogenic/therapy
MH  - Echocardiography
MH  - Retrospective Studies
EDAT- 2022/11/01 06:00
MHDA- 2022/11/03 06:00
CRDT- 2022/10/31 22:12
PHST- 2022/10/31 22:12 [entrez]
PHST- 2022/11/01 06:00 [pubmed]
PHST- 2022/11/03 06:00 [medline]
AID - 31879 [pii]
AID - 10.4037/ajcc2022588 [doi]
PST - ppublish
SO  - Am J Crit Care. 2022 Nov 1;31(6):483-493. doi: 10.4037/ajcc2022588.