A comparison of existing risk prediction models in patients undergoing venoarterial extracorporeal membrane oxygenation

Worku, Berhane; Gaudino, Mario; Avgerinos, Dimitrios V.; Ramasubbu, Kumudha; Gambardella, Ivancarmine; Gulkarov, Iosif; Khin, Sandi

doi:10.1016/j.hrtlng.2020.03.004

Cited by 11 publications

(10 citation statements)

References 22 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As such, MPM apps should include relevant laboratory values such as D-dimer and neutrophil to lymphocyte ratio [75][76][77][78][79][80], to better predict ICU mortality risk for patients with COVID-19. These findings are consistent with recent COVID-19 clinical trials, which also used SOFA and APACHE II most frequently [17,74,75,[81][82][83]. Some pandemic triage plans and protocols [84][85][86] recommend the use of SOFA MPMs for diagnosis and management of COVID-19, while others do not [87].…”

Section: Discussionsupporting

confidence: 86%

“…For example, the high-risk patient vignette had a SOFA score of 18 but was not on mechanical ventilation, which most of the higher risk of ICU mortality patients are on. On the other hand, the mean SOFA calculated for lower-risk patient vignettes was similar to hospitalized COVID-19 patients [17,74,75,[81][82][83], who do have a high risk of mortality. A better solution for developing vignettes to evaluate the quality of the information provided by apps can be found in published papers where vignettes are based on the mean values of clinical parameters.…”

Section: Discussionmentioning

confidence: 57%

See 1 more Smart Citation

A Review of Mortality Risk Prediction Models in Smartphone Applications

et al. 2021

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 57%

A Review of Mortality Risk Prediction Models in Smartphone Applications

et al. 2021

View full text Add to dashboard Cite

“…Prior studies have found mortality rates ranging from 29% to 54%. 6,8,21 This range is slightly higher than that found in our study (25%, n = 5). We suspect this is likely due to the relatively small sample size of patients in our study.…”

Section: Discussioncontrasting

confidence: 76%

Posterior Segment Findings in Patients on Extracorporeal Membrane Oxygenation

Blegen

Plaster

Hobbs

et al. 2020

Journal of VitreoRetinal Diseases

View full text Add to dashboard Cite

Purpose: Extracorporeal membrane oxygenation (ECMO) is an established treatment modality for critically ill patients with cardiopulmonary failure, yet little is known of the ocular pathology in this population. The aim of this study is to characterize the posterior segment findings of ECMO patients. Methods: This study is a retrospective analysis of 20 ECMO patients evaluated by ophthalmology from September 2012 to May 2019 at a level 1 trauma center. Comprehensive examinations assessed for intraocular pathology. Demographic data, exam findings, and mortality were analyzed. Results: The sample size consisted of 20 patients; a majority were male (75%), and mean age was 37.4 years (interquartile range, 26.75-50 years). All patients received ECMO for care of acute respiratory distress syndrome (ARDS). Average duration of ECMO therapy was 9.6 ± 6.5 days. Eleven (55%) patients had acute retinal pathology, including Purtscher-like retinopathy (20%), intraocular hemorrhage (50%), and septic chorioretinitis (bacterial or fungal, 10%). Location of hemorrhage included the retina (40%), vitreous (30%), and optic disc (15%). Sixty percent (n = 12) of patients were unable to provide a subjective history on initial assessment. Ultimately, 5 out of 20 patients (25%) died of systemic illness during their hospital stay. Conclusion: This study demonstrates high rates of retinal pathology, most commonly vitreous and/or retinal hemorrhage alongside a Purtscher-like retinopathy. This is likely secondary to complications of anticoagulation, microthrombi, septicemia, and hemodynamic instability. We found a mortality rate slightly lower than that of prior ECMO studies. Prospective studies with pre-ECMO and post-ECMO fundus photography is warranted for better understanding of these medically complex patients.

show abstract

“…To answer that question in the affirmative, we must first acknowledge that reliable prediction models for the development of PCS do not exist, and those advanced to anticipate survival after venoarterial ECMO carry modest discriminatory ability. 20 Given the restricted predictability of PCS and the limited success of standard of care strategies for the management of PCS, a new approach is warranted. In this regard, it would be wise to borrow a page from the ongoing efforts by our colleagues in the interventional cardiology community where new thinking to limit postmyocardial infarct size has evolved.…”

Section: Preemptive Left Ventricular Unloading: Exploring a New Paradigmmentioning

confidence: 99%