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Published in: Heart and Vessels 1/2018

01-01-2018 | Original Article

Determinants of survival and favorable neurologic outcomes in ischemic heart disease treated by veno-arterial extracorporeal membrane oxygenation

Authors: Keisuke Yonezu, Kenichi Sakakura, Yusuke Watanabe, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-ichi Momomura, Hideo Fujita

Published in: Heart and Vessels | Issue 1/2018

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Abstract

Overall mortality and neurologic outcome of patients treated by veno-arterial extracorporeal membrane oxygenation (V-A ECMO) was still not satisfactory. The aim of this study was to clarify the determinants of survival and favorable neurologic outcomes in patients with ischemic heart disease (IHD) treated by V-A ECMO. We identified IHD patients who received V-A ECMO, and divided those patients into the survived and the in-hospital death group. Multivariate logistic regression analysis was performed to identify the determinants of survival and favorable neurologic outcomes. Fifty-eight patients were divided into the in-hospital death group (n = 35) and the survived group (n = 23). Cardiogenic arrest for the reason for V-A ECMO introduction (vs. non-cardiac arrest: OR 0.34, 95% CI 0.002–0.65, P = 0.03) and final thrombolysis in myocardial infarction (TIMI-3) flow grade (vs. TIMI ≤2 flow grade: OR 17.44, 95% CI 1.65–184.04, P = 0.02) were determinants of in-hospital survival. Time from collapse to initiation of V-A ECMO was inversely associated with favorable neurologic function (10 min increase; OR 0.49, 95% CI 0.28–0.89, P = 0.02), while final TIMI-3 flow grade was not associated with favorable neurologic function. In conclusion, the rapid establishment of V-A ECMO system as well as obtaining TIMI-3 flow grade should be sought for better survival with maintaining neurological function in IHD patients who requires V-A ECMO.
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Metadata
Title
Determinants of survival and favorable neurologic outcomes in ischemic heart disease treated by veno-arterial extracorporeal membrane oxygenation
Authors
Keisuke Yonezu
Kenichi Sakakura
Yusuke Watanabe
Yousuke Taniguchi
Kei Yamamoto
Hiroshi Wada
Shin-ichi Momomura
Hideo Fujita
Publication date
01-01-2018
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 1/2018
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-017-1031-2

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