Impact of pulse pressure on clinical outcome in extracorporeal cardiopulmonary resuscitation (eCPR) patients
Authors:
Jonathan Rilinger, Antonia M. Riefler, Xavier Bemtgen, Markus Jäckel, Viviane Zotzmann, Paul M. Biever, Daniel Duerschmied, Christoph Benk, Georg Trummer, Klaus Kaier, Christoph Bode, Dawid L. Staudacher, Tobias Wengenmayer
Hemodynamic response to successful extracorporeal cardiopulmonary resuscitation (eCPR) is not uniform. Pulse pressure (PP) as a correlate for myocardial damage or recovery from it, might be a valuable tool to estimate the outcome of these patients.
Methods
We report retrospective data of a single-centre registry of eCPR patients, treated at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 01/2017 and 01/2020. The association between PP of the first 10 days after eCPR and hospital survival was investigated. Moreover, patients were divided into three groups according to their PP [low (0–9 mmHg), mid (10–29 mmHg) and high (≥ 30 mmHg)] at each time point.
Results
One hundred forty-three patients (age 63 years, 74.1% male, 40% OHCA, average low flow time 49 min) were analysed. Overall hospital survival rate was 28%. A low PP both early after eCPR (after 1, 3, 6 and 12 h) and after day 1 to day 8 was associated with reduced hospital survival. At each time point (1 h to day 5) the classification of patients into a low, mid and high PP group was able to categorize the patients for a low (5–20%), moderate (20–40%) and high (50–70%) survival rate. A multivariable analysis showed that the mean PP of the first 24 h was an independent predictor for survival (p = 0.008).
Conclusion
In this analysis, PP occurred to be a valuable parameter to estimate survival and maybe support clinical decision making in the further course of patients after eCPR.
Impact of pulse pressure on clinical outcome in extracorporeal cardiopulmonary resuscitation (eCPR) patients
Authors
Jonathan Rilinger Antonia M. Riefler Xavier Bemtgen Markus Jäckel Viviane Zotzmann Paul M. Biever Daniel Duerschmied Christoph Benk Georg Trummer Klaus Kaier Christoph Bode Dawid L. Staudacher Tobias Wengenmayer