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P1713Predictors of mortality following extracorporeal membrane oxygenation support in a large unselected critically ill patient population

Authors :
István Édes
Levente Fazekas
Balázs Tamás Németh
Dávid Becker
Endre Németh
Miklós Pólos
István Hartyánszky
B Merkely
Bálint Szilveszter
Source :
European Heart Journal. 40
Publication Year :
2019
Publisher :
Oxford University Press (OUP), 2019.

Abstract

Background Mechanical circulatory support (MCS) has been established as a means of augmenting circulation in critically ill patients due to a variety of underlying clinical reasons. Different methods of MCS may be applied with the venous-arterial extracorporeal membrane oxygenation (VA-ECMO) system being one of the most utilized in everyday care. Objectives Our aim was to determine independent predictors of mortality following VA-ECMO therapy in a large, unselected, adult, critically ill patient population requiring MCS. Methods Data on 181 consecutive, real-world VA-ECMO treatments have been assessed. Analysis was conducted for all subjects requiring MCS with the VA-ECMO as first instalment, regardless of underlying cause or eventual upgrade. All potential clinical factors influencing mortality were examined and evaluated. Results Overall mortality amounted to ≈65% at a median follow-up of 28 days and depended upon: glomerular filtration rate of 0.05). Surprisingly, neither the need for resuscitation during MCS nor any ECMO implantation indication influenced mortality by itself (p>0.05). Conclusions We have found that mortality in critically ill patients requiring VA-ECMO use remains very high. Decreased renal function and advanced age were found to influence mortality in our all-comers patient population, while traditional predictors of cardiovascular mortality did not have a significant effect on survival.

Details

ISSN :
15229645 and 0195668X
Volume :
40
Database :
OpenAIRE
Journal :
European Heart Journal
Accession number :
edsair.doi...........ebe19d6fabf9012bc01ac2a7baf2a779
Full Text :
https://doi.org/10.1093/eurheartj/ehz748.0468