Analysis of early volume balance and prognosis of severe cardiogenic shock patients treated with veno-arterial extracorporeal membrane oxygenation
10.3760/cma.j.issn.1671-0282.2021.10.004
- VernacularTitle:静脉-动脉体外膜氧合治疗的严重心源性休克患者早期容量平衡与预后分析
- Author:
Feng SUN
1
;
Xufeng CHEN
;
Jinsong ZHANG
;
Yong MEI
;
Jinru LV
;
Wei LI
;
Deliang HU
;
Gang ZHANG
;
Huazhong ZHANG
;
Yuan GUO
;
Juan WU
;
Yongxia GAO
;
Xihua HUANG
;
Hui ZHANG
Author Information
1. 南京医科大学第一附属医院急诊医学中心 210029
- Keywords:
Veno-arterial extracorporeal membrane oxygenation;
Cardiogenic shock;
Volume management;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2021;30(10):1182-1186
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the early volume characteristics of patients with severe cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and the relationship between their early volume and the prognosis.Methods:This study reviewed patients of Emergency Medical University , treated with VA-ECMO and screened the patients with severe cardiogenic shock and VA-ECMO running more than 72 h for further study. The basic condition of the patients was recorded, and the fluid balance in the first 72 h was analyzed. The patients were grouped according to their fluid balance in the first 72 h. The gender, age, survival rate, continuous renal replacement therapy (CRRT) rate, intra-aortic balloon pump (IABP) rate, and invasive mechanical ventilation rate were compared between the two groups, and the relative risk to the prognosis was calculated. The prognosis was compared between the two groups. Results:Totally 77 patients with severe cardiogenic shock were enrolled. Forty-one cases survived, with an overall survival rate of 53.2%. The volume balance at 48-72 h and the total volume balance at the first 72 h were different between the survival and dead groups. Compared with the positive balance group, patients in the negative balance group were less likely to receive CRRT or invasive mechanical ventilation during the first 72 h. Patients in the negative balance group during the first 72 h had a better survival rate, and their relative risk of survival was 1.81 (95% confidence interval: 1.101, 2.985). However, there was no significant difference in survival rate according to every 24 h fluid balance.Conclusions:Patients with severe cardiogenic shock treated with VA-ECMO who had negative total volume balance during the first 72 h are more likely to survive and less likely to require CRRT or invasive mechanical ventilation.
