Laboratory and clinical predictors of 30-day survival for patients on Extracorporeal Membrane Oxygenation (ECMO): 8-Year experience at Albert Einstein College of Medicine, Montefiore Medical Center

Francischetti, Ivo M.B.; Szymanski, James; Rodríguez, Daniel; Heo, Moonseong; Wolgast, Lucia R.

doi:10.1016/j.jcrc.2017.03.027

Cited by 16 publications

(12 citation statements)

References 77 publications

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“…A significantly higher proportion of patients in the LMWH group (80%) were on venoarterial ECMO support, compared to the UFH group (31.8%, P < .01). In previous studies, venoarterial ECMO was associated with a higher risk of bleeding compared to a venovenous mode . Although one could, therefore, argue that patients in the LMWH group were at higher risk for bleeding, we observed no difference in bleeding between the two groups.…”

Section: Discussioncontrasting

confidence: 71%

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

et al. 2020

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Extracorporeal membrane oxygenation (ECMO) is gaining importance in the perioperative management of lung transplant patients. To date, the ideal substance for anticoagulation of ECMO patients is still a matter of debate. In this study, we describe our experience with the use of low molecular weight heparin (LMWH) in comparison with unfractioned heparin (UFH) in lung transplant patients undergoing perioperative ECMO support. We retrospectively analyzed data from all lung transplant patients who underwent perioperative ECMO support at our institution between 2013 and 2017. Bleeding events served as primary outcome parameter. Secondary outcome parameters consisted of thromboembolic events. 102 patients were included in this study, of which 22 (21.6%) received UFH for anticoagulation, and 80 (78.4%) received LMWH. There was no difference between the two groups in regard to serious bleeding events (22.7% in the UFH group vs 12.5% in the LMWH group, P = .31). However, the proportion of patients experiencing thromboembolic events was significantly higher in the UFH group than in the LMWH group (50% vs 20%, P = .01). After adjusting for baseline differences between the two groups, we still observed a difference with respect to thromboembolic events. These data remain to be validated in future prospective, randomized trials.

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Section: Discussioncontrasting

confidence: 71%

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

et al. 2020

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“…It can occur within 2 h of ECMO cannulation ( 13 , 14 , 22 ). In contrast to CPB where the number of leukocytes increased during open heart surgeries ( 40 , 43 ), leukocytopenia has long been reported in ECMO ( 16 , 25 ). Differences could be associated with the pathophysiology between ECMO and CPB patients, and the involvement of other immune triggers (e.g.…”

Section: Ecmo As a Second “Hit” To Leukocyte Pathophysiology In Critimentioning

confidence: 99%

Current Understanding of Leukocyte Phenotypic and Functional Modulation During Extracorporeal Membrane Oxygenation: A Narrative Review

Millar

Langguth

et al. 2021

Front. Immunol.

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A plethora of leukocyte modulations have been reported in critically ill patients. Critical illnesses such as acute respiratory distress syndrome and cardiogenic shock, which potentially require extracorporeal membrane oxygenation (ECMO) support, are associated with changes in leukocyte numbers, phenotype, and functions. The changes observed in these illnesses could be compounded by exposure of blood to the non-endothelialized surfaces and non-physiological conditions of ECMO. This can result in further leukocyte activation, increased platelet-leukocyte interplay, pro-inflammatory and pro-coagulant state, alongside features of immunosuppression. However, the effects of ECMO on leukocytes, in particular their phenotypic and functional signatures, remain largely overlooked, including whether these changes have attributable mortality and morbidity. The aim of our narrative review is to highlight the importance of studying leukocyte signatures to better understand the development of complications associated with ECMO. Increased knowledge and appreciation of their probable role in ECMO-related adverse events may assist in guiding the design and establishment of targeted preventative actions.

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“…[11][12][13][14][15] Our study has shown that laboratory values of kidney function precannulation (pH, creatinine) and day-1 (pH, bicarbonate) are associated with poor outcomes similar to other studies. 16 Moreover, our multivariate analysis indicated that pH was an independent predictor of mortality. Chloride, regulate the acid-base balance in the body, and the balance is organized by the kidneys.…”

Section: Discussionmentioning

confidence: 75%

“…Hypo-and hyperchloremia were associated with poor results in critical patients. [16][17][18][19][20] These results showed that kidney dysfunction contributed to mortality in critical pediatric patients. 21 Urine output declines due to the renal perfusion decrease in the presence of low cardiac flow.…”

Section: Discussionmentioning

confidence: 76%

Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)

Şık¹,

Demirbuğa²,

Temur³

et al. 2020

Turk J Pediatr

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Extracorporeal membrane oxygenation (ECMO) is used in pediatric patients with severe cardiopulmonary failure who do not respond to conventional therapy; only a few studies have been conducted in Turkey. We present the experience of pediatric ECMO with the aim of showing factors affecting mortality. We retrospectively reviewed our ECMO database to identify patients who received ECMO from October 2015 to March 2018. Our population comprised 30 pediatric patients. The mean patient age was 41.31±53.35 months and 17 (56.7%) patients were male. The median duration of ECMO support was 8.9 (6.6-10.8) days. The rates of successful ECMO weaning and survival to discharge were 70.0% (n=21) and 66.7% (n=20), respectively. Indications for ECMO were respiratory failure (40.0%), cardiac failure (33.3%), and sepsis (26.7%). We found that pre-cannulation values of pH (p=0.034), leukocytes (p=0.029), C-reactive protein (p=0.045), creatinine (p=0.047), chloride (p=0.001) and post-cannulation pH (p=0.0001), bicarbonate (p=0.014), lactate (p=0.002), chloride (p=0.0001) were associated with mortality. The results showed that preexisting sepsis and renal conditions contributed to poor outcomes. Indications, ECMO onset time, and pre-and post-cannulation laboratory values such as leukocytes, CRP, creatinine, bicarbonate, lactate, and chloride are factors that affect outcomes.

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Laboratory and clinical predictors of 30-day survival for patients on Extracorporeal Membrane Oxygenation (ECMO): 8-Year experience at Albert Einstein College of Medicine, Montefiore Medical Center

Cited by 16 publications

References 77 publications

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

Low molecular weight heparin versus unfractioned heparin for anticoagulation during perioperative extracorporeal membrane oxygenation: A single center experience in 102 lung transplant patients

Current Understanding of Leukocyte Phenotypic and Functional Modulation During Extracorporeal Membrane Oxygenation: A Narrative Review

Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)

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