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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2021 | Myocarditis | Original research

Effect of arterial oxygen partial pressure inflection point on Venoarterial extracorporeal membrane oxygenation for emergency cardiac support

Authors: Hao Zhou, Yi Zhu, Zhongman Zhang, Jinru Lv, Wei Li, Deliang Hu, Xufeng Chen, Yong Mei

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2021

Abstract

Background

Temporary circulatory support is a bridge between acute circulatory failure and definitive treatment or recovery. Currently, venoarterial extracorporeal membrane oxygenation (VA-ECMO) is considered to be one of the effective circulatory support methods, although cardiac function monitoring during the treatment still needs further investigation. Inflection point of arterial oxygen partial pressure (IPPaO2) may occur at an early stage in part of patients with a good prognosis after VA-ECMO treatment, and the relationship between time of IPPaO2 (tIPPaO2) and recovery of cardiac function or prognosis remains unclear.

Methods

To investigate this relationship, we retrospectively analyzed the clinical data of 71 patients with different conditions after treatment with VA-ECMO in the emergency center of Jiangsu Province Hospital between May 2015 and July 2020. Spearman’s correlation analysis was used for the correlation between tIPPaO₂ and quantitative data, and ROC curve for the predictive effect of tIPPaO₂ on the 28-day mortality.

Results

Thirty-five patients were admitted because of refractory cardiogenic shock (26 of 35 survived) and the remaining 36 patients due to cardiac arrest (13 of 36 survived). The overall survival rate was 54.9% (39 of 71 survived). Acute physiology and chronic health evaluation II, ECMO time, tIPPaO2, continuous renal replacement therapy time, mechanical ventilation time, and bleeding complications in the survival group were lower than those in the non-survival group, with length of stay, intensive care unit stay, and platelet levels were being higher. The tIPPaO₂ was negatively correlated with ejection fraction, and the shorter tIPPaO2 resulted in a higher 28-day survival probability, higher predictive value for acute myocardial infarction and fulminant myocarditis.

Conclusions

Therefore, tIPPaO2 could be a reliable qualitative indicator of cardiac function in patients treated with VA-ECMO, which can reveal appropriate timing for adjusting VA-ECMO flow or weaning.

Trial registration

ChiCTR1900026105.

Available only for authorised users

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Title: Effect of arterial oxygen partial pressure inflection point on Venoarterial extracorporeal membrane oxygenation for emergency cardiac support
Authors: Hao Zhou
Yi Zhu
Zhongman Zhang
Jinru Lv
Wei Li
Deliang Hu
Xufeng Chen
Yong Mei
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Myocarditis
Cardiogenic Shock
Cardiogenic Shock
ECMO
ECMO
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2021
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/s13049-021-00902-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of arterial oxygen partial pressure inflection point on Venoarterial extracorporeal membrane oxygenation for emergency cardiac support

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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