Impact of pulse pressure on clinical outcome in extracorporeal cardiopulmonary resuscitation (eCPR) patients
Background Hemodynamic response to successful extracorporeal cardiopulmonary resuscitation (eCPR) is not uniform. Pulse pressure (PP) as a correlate for myocardial damage or recovery from it, might be a valuable tool to estimate the outcome of these patients. Methods We report retrospective data of a single-centre registry of eCPR patients, treated at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 01/2017 and 01/2020. The association between PP of the first 10 days after eCPR and hospital survival was investigated. Moreover, patients were divided into three groups according to their PP [low (0–9 mmHg), mid (10–29 mmHg) and high (≥ 30 mmHg)] at each time point. Results One hundred forty-three patients (age 63 years, 74.1% male, 40% OHCA, average low flow time 49 min) were analysed. Overall hospital survival rate was 28%. A low PP both early after eCPR (after 1, 3, 6 and 12 h) and after day 1 to day 8 was associated with reduced hospital survival. At each time point (1 h to day 5) the classification of patients into a low, mid and high PP group was able to categorize the patients for a low (5–20%), moderate (20–40%) and high (50–70%) survival rate. A multivariable analysis showed that the mean PP of the first 24 h was an independent predictor for survival (p = 0.008). Conclusion In this analysis, PP occurred to be a valuable parameter to estimate survival and maybe support clinical decision making in the further course of patients after eCPR. Graphic abstract.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:110 |
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| Enthalten in: |
Clinical research in cardiology - 110(2021), 9 vom: 29. März, Seite 1473-1483 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rilinger, Jonathan [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
ECPR |
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| Anmerkungen: |
© The Author(s) 2021 |
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| doi: |
10.1007/s00392-021-01838-7 |
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| PPN (Katalog-ID): |
OLC2127477642 |
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| 520 | |a Background Hemodynamic response to successful extracorporeal cardiopulmonary resuscitation (eCPR) is not uniform. Pulse pressure (PP) as a correlate for myocardial damage or recovery from it, might be a valuable tool to estimate the outcome of these patients. Methods We report retrospective data of a single-centre registry of eCPR patients, treated at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 01/2017 and 01/2020. The association between PP of the first 10 days after eCPR and hospital survival was investigated. Moreover, patients were divided into three groups according to their PP [low (0–9 mmHg), mid (10–29 mmHg) and high (≥ 30 mmHg)] at each time point. Results One hundred forty-three patients (age 63 years, 74.1% male, 40% OHCA, average low flow time 49 min) were analysed. Overall hospital survival rate was 28%. A low PP both early after eCPR (after 1, 3, 6 and 12 h) and after day 1 to day 8 was associated with reduced hospital survival. At each time point (1 h to day 5) the classification of patients into a low, mid and high PP group was able to categorize the patients for a low (5–20%), moderate (20–40%) and high (50–70%) survival rate. A multivariable analysis showed that the mean PP of the first 24 h was an independent predictor for survival (p = 0.008). Conclusion In this analysis, PP occurred to be a valuable parameter to estimate survival and maybe support clinical decision making in the further course of patients after eCPR. Graphic abstract | ||
| 650 | 4 | |a Pulse pressure | |
| 650 | 4 | |a Extracorporeal cardiopulmonary resuscitation | |
| 650 | 4 | |a eCPR | |
| 650 | 4 | |a Veno-arterial extracorporeal membrane oxygenation | |
| 650 | 4 | |a Outcome | |
| 700 | 1 | |a Riefler, Antonia M. |4 aut | |
| 700 | 1 | |a Bemtgen, Xavier |4 aut | |
| 700 | 1 | |a Jäckel, Markus |4 aut | |
| 700 | 1 | |a Zotzmann, Viviane |4 aut | |
| 700 | 1 | |a Biever, Paul M. |4 aut | |
| 700 | 1 | |a Duerschmied, Daniel |4 aut | |
| 700 | 1 | |a Benk, Christoph |4 aut | |
| 700 | 1 | |a Trummer, Georg |4 aut | |
| 700 | 1 | |a Kaier, Klaus |4 aut | |
| 700 | 1 | |a Bode, Christoph |4 aut | |
| 700 | 1 | |a Staudacher, Dawid L. |4 aut | |
| 700 | 1 | |a Wengenmayer, Tobias |4 aut | |
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