Venoarterial extracorporeal membrane oxygenation in adult patients: Predictors of mortality

Jingwen Li, Cun Long, Song Lou, Feilong Hei, Kun Yu, Shigang Wang, Shengshou Hu, Jianping Xu, Qian Chang, Ping Liu, Haitao Zhang, Hansong Sun, Wei Wang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. In this study, we reviewed our experience with extracorporeal membrane oxygenation support and tried to identify measurable values which might predict in-hospital mortality. Methods: From January 2004 through December 2008, 50 of 21,298 adult patients received venoarterial extracorporeal membrane oxygenation. We retrospectively analyzed clinical records of these 50 consecutive patients. Details of demographics, preoperative measurements, clinical characteristics at the time of extracorporeal membrane oxygenation implantation, extracorporeal membrane oxygenation-related complications and in-hospital mortality were collected. Logistic regression analyses were performed to investigate predictors of mortality. A p-value ≤ 0.05 was accepted as significant. Results: Thirty-eight patients were weaned from extracorporeal membrane oxygenation and 33 patients survived to discharge. The overall survival rate was 66%. In a multiple logistic regression analysis, blood lactate level before initiation of extracorporeal membrane oxygenation was a risk factor associated with in-hospital mortality (OR 1.27 95% CI 1.042-1.542). To evaluate the utility of the lactate in predicting mortality, a conventional receiver operating characteristic curve was produced. Sensitivity and specificity were optimal at a cut-off point of 12.6mmol/L, with an area under the curve of 0.752. The positive and negative predictive values were 73.3% and 83.9%, respectively. Conclusions: Extracorporeal membrane oxygenation is a justifiable alternative treatment for postoperative refractory cardiac and pulmonary dysfunction which could rescue more than sixty percent of otherwise fatal patients. Patients with pre-extracorporeal membrane oxygenation lactate levels above 12.6mmol/L are at higher risks for in-hospital death. Evidence-based therapy for this group of high risk patients is needed.

Original languageEnglish (US)
Pages (from-to)225-230
Number of pages6
JournalPerfusion
Volume24
Issue number4
DOIs
StatePublished - Jul 1 2009

Fingerprint

Extracorporeal Membrane Oxygenation
Oxygenation
mortality
Membranes
Mortality
Hospital Mortality
logistics
Lactic Acid
Logistics
Values
Logistic Models
regression analysis
Regression Analysis
recipient
death
regression
Group Psychotherapy
Regression analysis
ROC Curve
Refractory materials

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Li, J., Long, C., Lou, S., Hei, F., Yu, K., Wang, S., ... Wang, W. (2009). Venoarterial extracorporeal membrane oxygenation in adult patients: Predictors of mortality. Perfusion, 24(4), 225-230. https://doi.org/10.1177/0267659109348725
Li, Jingwen ; Long, Cun ; Lou, Song ; Hei, Feilong ; Yu, Kun ; Wang, Shigang ; Hu, Shengshou ; Xu, Jianping ; Chang, Qian ; Liu, Ping ; Zhang, Haitao ; Sun, Hansong ; Wang, Wei. / Venoarterial extracorporeal membrane oxygenation in adult patients : Predictors of mortality. In: Perfusion. 2009 ; Vol. 24, No. 4. pp. 225-230.
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abstract = "Background: Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. In this study, we reviewed our experience with extracorporeal membrane oxygenation support and tried to identify measurable values which might predict in-hospital mortality. Methods: From January 2004 through December 2008, 50 of 21,298 adult patients received venoarterial extracorporeal membrane oxygenation. We retrospectively analyzed clinical records of these 50 consecutive patients. Details of demographics, preoperative measurements, clinical characteristics at the time of extracorporeal membrane oxygenation implantation, extracorporeal membrane oxygenation-related complications and in-hospital mortality were collected. Logistic regression analyses were performed to investigate predictors of mortality. A p-value ≤ 0.05 was accepted as significant. Results: Thirty-eight patients were weaned from extracorporeal membrane oxygenation and 33 patients survived to discharge. The overall survival rate was 66{\%}. In a multiple logistic regression analysis, blood lactate level before initiation of extracorporeal membrane oxygenation was a risk factor associated with in-hospital mortality (OR 1.27 95{\%} CI 1.042-1.542). To evaluate the utility of the lactate in predicting mortality, a conventional receiver operating characteristic curve was produced. Sensitivity and specificity were optimal at a cut-off point of 12.6mmol/L, with an area under the curve of 0.752. The positive and negative predictive values were 73.3{\%} and 83.9{\%}, respectively. Conclusions: Extracorporeal membrane oxygenation is a justifiable alternative treatment for postoperative refractory cardiac and pulmonary dysfunction which could rescue more than sixty percent of otherwise fatal patients. Patients with pre-extracorporeal membrane oxygenation lactate levels above 12.6mmol/L are at higher risks for in-hospital death. Evidence-based therapy for this group of high risk patients is needed.",
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Li, J, Long, C, Lou, S, Hei, F, Yu, K, Wang, S, Hu, S, Xu, J, Chang, Q, Liu, P, Zhang, H, Sun, H & Wang, W 2009, 'Venoarterial extracorporeal membrane oxygenation in adult patients: Predictors of mortality', Perfusion, vol. 24, no. 4, pp. 225-230. https://doi.org/10.1177/0267659109348725

Venoarterial extracorporeal membrane oxygenation in adult patients : Predictors of mortality. / Li, Jingwen; Long, Cun; Lou, Song; Hei, Feilong; Yu, Kun; Wang, Shigang; Hu, Shengshou; Xu, Jianping; Chang, Qian; Liu, Ping; Zhang, Haitao; Sun, Hansong; Wang, Wei.

In: Perfusion, Vol. 24, No. 4, 01.07.2009, p. 225-230.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Venoarterial extracorporeal membrane oxygenation in adult patients

T2 - Predictors of mortality

AU - Li, Jingwen

AU - Long, Cun

AU - Lou, Song

AU - Hei, Feilong

AU - Yu, Kun

AU - Wang, Shigang

AU - Hu, Shengshou

AU - Xu, Jianping

AU - Chang, Qian

AU - Liu, Ping

AU - Zhang, Haitao

AU - Sun, Hansong

AU - Wang, Wei

PY - 2009/7/1

Y1 - 2009/7/1

N2 - Background: Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. In this study, we reviewed our experience with extracorporeal membrane oxygenation support and tried to identify measurable values which might predict in-hospital mortality. Methods: From January 2004 through December 2008, 50 of 21,298 adult patients received venoarterial extracorporeal membrane oxygenation. We retrospectively analyzed clinical records of these 50 consecutive patients. Details of demographics, preoperative measurements, clinical characteristics at the time of extracorporeal membrane oxygenation implantation, extracorporeal membrane oxygenation-related complications and in-hospital mortality were collected. Logistic regression analyses were performed to investigate predictors of mortality. A p-value ≤ 0.05 was accepted as significant. Results: Thirty-eight patients were weaned from extracorporeal membrane oxygenation and 33 patients survived to discharge. The overall survival rate was 66%. In a multiple logistic regression analysis, blood lactate level before initiation of extracorporeal membrane oxygenation was a risk factor associated with in-hospital mortality (OR 1.27 95% CI 1.042-1.542). To evaluate the utility of the lactate in predicting mortality, a conventional receiver operating characteristic curve was produced. Sensitivity and specificity were optimal at a cut-off point of 12.6mmol/L, with an area under the curve of 0.752. The positive and negative predictive values were 73.3% and 83.9%, respectively. Conclusions: Extracorporeal membrane oxygenation is a justifiable alternative treatment for postoperative refractory cardiac and pulmonary dysfunction which could rescue more than sixty percent of otherwise fatal patients. Patients with pre-extracorporeal membrane oxygenation lactate levels above 12.6mmol/L are at higher risks for in-hospital death. Evidence-based therapy for this group of high risk patients is needed.

AB - Background: Extracorporeal membrane oxygenation is a cardiopulmonary supportive therapy. In this study, we reviewed our experience with extracorporeal membrane oxygenation support and tried to identify measurable values which might predict in-hospital mortality. Methods: From January 2004 through December 2008, 50 of 21,298 adult patients received venoarterial extracorporeal membrane oxygenation. We retrospectively analyzed clinical records of these 50 consecutive patients. Details of demographics, preoperative measurements, clinical characteristics at the time of extracorporeal membrane oxygenation implantation, extracorporeal membrane oxygenation-related complications and in-hospital mortality were collected. Logistic regression analyses were performed to investigate predictors of mortality. A p-value ≤ 0.05 was accepted as significant. Results: Thirty-eight patients were weaned from extracorporeal membrane oxygenation and 33 patients survived to discharge. The overall survival rate was 66%. In a multiple logistic regression analysis, blood lactate level before initiation of extracorporeal membrane oxygenation was a risk factor associated with in-hospital mortality (OR 1.27 95% CI 1.042-1.542). To evaluate the utility of the lactate in predicting mortality, a conventional receiver operating characteristic curve was produced. Sensitivity and specificity were optimal at a cut-off point of 12.6mmol/L, with an area under the curve of 0.752. The positive and negative predictive values were 73.3% and 83.9%, respectively. Conclusions: Extracorporeal membrane oxygenation is a justifiable alternative treatment for postoperative refractory cardiac and pulmonary dysfunction which could rescue more than sixty percent of otherwise fatal patients. Patients with pre-extracorporeal membrane oxygenation lactate levels above 12.6mmol/L are at higher risks for in-hospital death. Evidence-based therapy for this group of high risk patients is needed.

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U2 - 10.1177/0267659109348725

DO - 10.1177/0267659109348725

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VL - 24

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