Pulse pressure within the first 2 days of veno-arterial extracorporeal membrane oxygenation is predictive of death prior to hospital discharge, renal dysfunction requiring dialysis and pulmonary oedema.
Siriwardena, M
Breeding, J
Gopalakrishnan, M
Jansz, P
Granger, EK
Jackson, A
MacDonald, PS
Lowe, D
Buscher, H
Nair, P
- Publisher:
- SAGE Publications
- Publication Type:
- Journal Article
- Citation:
- Perfusion, 2023, 38, (8), pp. 1568-1576
- Issue Date:
- 2023-11
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siriwardena-et-al-2022-pulse-pressure-within-the-first-2-days-of-veno-arterial-extracorporeal-membrane-oxygenation-is.pdf | Published version | 734.58 kB | Adobe PDF |
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Siriwardena, M | |
dc.contributor.author | Breeding, J | |
dc.contributor.author | Gopalakrishnan, M | |
dc.contributor.author | Jansz, P | |
dc.contributor.author | Granger, EK | |
dc.contributor.author | Jackson, A | |
dc.contributor.author | MacDonald, PS | |
dc.contributor.author | Lowe, D | |
dc.contributor.author | Buscher, H | |
dc.contributor.author | Nair, P | |
dc.date.accessioned | 2024-04-09T22:35:48Z | |
dc.date.available | 2024-04-09T22:35:48Z | |
dc.date.issued | 2023-11 | |
dc.identifier.citation | Perfusion, 2023, 38, (8), pp. 1568-1576 | |
dc.identifier.issn | 0267-6591 | |
dc.identifier.issn | 1477-111X | |
dc.identifier.uri | http://hdl.handle.net/10453/177629 | |
dc.description.abstract | BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) flows are titrated to achieve adequate perfusion while attempting to ideally maintain arterial pulse pressure (PP). We assessed risk in patients with low PP defined as <10 mmHg within the first 2 days of support. METHODS: Demographics, haemodynamics, echocardiographic and radiological findings were recorded retrospectively in cases conducted between 2014 and 2016. Outcomes were hospital mortality, requirement for renal replacement therapy (RRT) and severe pulmonary oedema (PO). RESULTS: Of 101 patients, 66.3% were male, mean age was 56 (range 18-71 years), mean duration of support was 6.3 days ± 4.1 days, 37.6% died prior to hospital discharge, 39.6% needed RRT and 11.9% had severe PO. Areas under the receiver operating curves of PP at 48 h for hospital mortality, RRT and severe PO were (respectively): 0.69 (95% CI 0.58-0.80, p = .001), 0.64 (95% CI 0.50-0.77, p = .044), 0.69 (95% CI 0.55-0.82, p = .009). The odds ratio for mortality, RRT, severe PO for those with low PP were (respectively) 2.8 (95% CI 1.01-7.5, p = .04), 3.1 (95% CI 1.11-8.40, p = .026), 7.6 (95% CI 2.06-27.89, p = .001). Central venous pressure, mean arterial pressure were not predictive. CONCLUSION: PP during the first 2 days of support is predictive of clinically important outcomes in patients supported with VA-ECMO. | |
dc.format | Print-Electronic | |
dc.language | eng | |
dc.publisher | SAGE Publications | |
dc.relation.ispartof | Perfusion | |
dc.relation.isbasedon | 10.1177/02676591221115935 | |
dc.rights | info:eu-repo/semantics/closedAccess | |
dc.subject | 1102 Cardiorespiratory Medicine and Haematology | |
dc.subject.classification | 3201 Cardiovascular medicine and haematology | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Extracorporeal Membrane Oxygenation | |
dc.subject.mesh | Pulmonary Edema | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Patient Discharge | |
dc.subject.mesh | Renal Dialysis | |
dc.subject.mesh | Kidney Diseases | |
dc.subject.mesh | Hospitals | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Pulmonary Edema | |
dc.subject.mesh | Kidney Diseases | |
dc.subject.mesh | Patient Discharge | |
dc.subject.mesh | Renal Dialysis | |
dc.subject.mesh | Extracorporeal Membrane Oxygenation | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Hospitals | |
dc.subject.mesh | Female | |
dc.subject.mesh | Male | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Male | |
dc.subject.mesh | Adolescent | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Aged | |
dc.subject.mesh | Female | |
dc.subject.mesh | Blood Pressure | |
dc.subject.mesh | Extracorporeal Membrane Oxygenation | |
dc.subject.mesh | Pulmonary Edema | |
dc.subject.mesh | Retrospective Studies | |
dc.subject.mesh | Patient Discharge | |
dc.subject.mesh | Renal Dialysis | |
dc.subject.mesh | Kidney Diseases | |
dc.subject.mesh | Hospitals | |
dc.title | Pulse pressure within the first 2 days of veno-arterial extracorporeal membrane oxygenation is predictive of death prior to hospital discharge, renal dysfunction requiring dialysis and pulmonary oedema. | |
dc.type | Journal Article | |
utslib.citation.volume | 38 | |
utslib.location.activity | England | |
utslib.for | 1102 Cardiorespiratory Medicine and Haematology | |
pubs.organisational-group | University of Technology Sydney | |
pubs.organisational-group | University of Technology Sydney/Faculty of Health | |
utslib.copyright.status | closed_access | * |
dc.date.updated | 2024-04-09T22:35:47Z | |
pubs.issue | 8 | |
pubs.publication-status | Published | |
pubs.volume | 38 | |
utslib.citation.issue | 8 |
Abstract:
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) flows are titrated to achieve adequate perfusion while attempting to ideally maintain arterial pulse pressure (PP). We assessed risk in patients with low PP defined as <10 mmHg within the first 2 days of support. METHODS: Demographics, haemodynamics, echocardiographic and radiological findings were recorded retrospectively in cases conducted between 2014 and 2016. Outcomes were hospital mortality, requirement for renal replacement therapy (RRT) and severe pulmonary oedema (PO). RESULTS: Of 101 patients, 66.3% were male, mean age was 56 (range 18-71 years), mean duration of support was 6.3 days ± 4.1 days, 37.6% died prior to hospital discharge, 39.6% needed RRT and 11.9% had severe PO. Areas under the receiver operating curves of PP at 48 h for hospital mortality, RRT and severe PO were (respectively): 0.69 (95% CI 0.58-0.80, p = .001), 0.64 (95% CI 0.50-0.77, p = .044), 0.69 (95% CI 0.55-0.82, p = .009). The odds ratio for mortality, RRT, severe PO for those with low PP were (respectively) 2.8 (95% CI 1.01-7.5, p = .04), 3.1 (95% CI 1.11-8.40, p = .026), 7.6 (95% CI 2.06-27.89, p = .001). Central venous pressure, mean arterial pressure were not predictive. CONCLUSION: PP during the first 2 days of support is predictive of clinically important outcomes in patients supported with VA-ECMO.
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