1
|
Dunton K, Weeks PA, Gulbis B, Jumean M, Kumar S, Janowiak L, Banjac I, Radovancevic R, Gregoric I, Kar B. Evaluation of Vasoactive-Inotropic Score and Survival to Decannulation in Adult Patients on Venoarterial Extracorporeal Life Support: An Observational Cohort Study. ASAIO J 2023; 69:873-878. [PMID: 37155964 DOI: 10.1097/mat.0000000000001982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Extracorporeal life support with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to assist circulation in patients with severe cardiogenic shock or cardiac arrest. The vasoactive-inotropic score (VIS) is a standardized calculation of vasoactive medication support which uses coefficients for each medication that converts them to an equivalent value. The purpose of this study was to assess the VIS as an early prognostication tool for survival to decannulation patients on adult VA-ECMO support. This was a single-center, observational cohort study of adult patients who received VA-ECMO support compared based on their survival to decannulation. The primary endpoint was the VIS at hour 24 postcannulation. Among the 265 patients included in this study, 140 patients (52.8%) survived to decannulation of VA-ECMO. At 24 hours postcannulation, a lower VIS was observed in the group that survived decannulation (6.5 ± 7.5 vs. 12.3 ± 16.9; p < 0.001). Multivariate analysis performed also demonstrates an association between 24-hour VIS and survival to decannulation (odds ratio 0.95; 95% confidence interval, 0.91-0.95). This study suggests that the 24-hour VIS may be an early prognostic indicator in patients on VA-ECMO patients. http://links.lww.com/ASAIO/B39.
Collapse
Affiliation(s)
- Kelly Dunton
- From the Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas
- Department of Pharmacy, AdventHealth, Orlando, Florida
| | - Phillip A Weeks
- From the Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas
| | - Brian Gulbis
- From the Department of Pharmacy, Memorial Hermann-Texas Medical Center, Houston, Texas
| | - Marwan Jumean
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Sachin Kumar
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Lisa Janowiak
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Igor Banjac
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Rajko Radovancevic
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Igor Gregoric
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| | - Biswajit Kar
- Department of Advanced Cardiopulmonary Therapies and Transplantation, Center for Advanced Heart Failure, University of Texas Health Science Center at Houston, Houston, Texas
| |
Collapse
|
2
|
Augoustides JG. Cardiopulmonary Resuscitation During the Coronavirus Crisis: Important Updates for the Cardiothoracic and Vascular Anesthesia Community. J Cardiothorac Vasc Anesth 2020; 34:2312-2314. [PMID: 32434725 PMCID: PMC7187853 DOI: 10.1053/j.jvca.2020.04.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 12/20/2022]
Affiliation(s)
- John G Augoustides
- Cardiovascular and Thoracic Section Department of Anesthesiology and Critical Care Perelman School of Medicine University of Pennsylvania Philadelphia, PA.
| |
Collapse
|
3
|
Hessel EA, Betz AC. The Challenges of Venoarterial ECMO for Postcardiotomy Shock. J Cardiothorac Vasc Anesth 2020; 35:48-50. [PMID: 32950347 DOI: 10.1053/j.jvca.2020.08.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 08/23/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Eugene A Hessel
- Department of Anesthesiology, University of Kentucky, Lexington, KY
| | | |
Collapse
|