New-Onset Atrial Arrhythmias Are Independently Associated With In-Hospital Mortality in Veno-Venous Extracorporeal Membrane Oxygenation.
J Cardiothorac Vasc Anesth
; 36(6): 1648-1655, 2022 06.
Статья
в английский
| MEDLINE | ID: covidwho-1991701
ABSTRACT
OBJECTIVE:
To explore if atrial arrhythmias are associated with in-hospital mortality in veno-venous extracorporeal membrane oxygenation (VV-ECMO) patients.DESIGN:
Retrospective observational cohort study.SETTING:
Quaternary care academic medical center.PARTICIPANTS:
Patients with respiratory failure requiring VV-ECMO for >24 hours between January 1, 2016, and January 1, 2019.INTERVENTIONS:
None, observational study. MEASUREMENTS AND MAINRESULTS:
Two hundred nineteen VV-ECMO patients were included. Patients were stratified by absence or presence of clinically significant atrial arrhythmias during the VV-ECMO run. Atrial arrhythmias were defined as either atrial fibrillation or atrial flutter that occurred during VV-ECMO and required pharmacologic or electrical intervention. The primary outcome was in-hospital mortality. Secondary outcomes included a composite of thrombotic events, which included ischemic stroke and on-pump arterial thrombosis. Other objectives of this analysis included characterization of atrial arrhythmia incidence, risk factors, and management. A total of 67 patients (30.5%) experienced new-onset atrial arrhythmias post-ECMO cannulation. Age, male sex, and norepinephrine use were independently associated with atrial arrhythmia development. In-hospital mortality was significantly higher in the atrial arrhythmia group (38.8% v 19.1%; p = 0.003). In the multivariate logistic regression analysis, atrial arrhythmias during VV-ECMO were independently associated with increased odds of in-hospital mortality (odds ratio, 2.21; 95% confidence interval, 1.08-4.55; p = 0.03), after controlling for Respiratory Extracorporeal Membrane Oxygenation Survival Prediction score, acute renal failure, total norepinephrine dose, and total cannulation time.CONCLUSIONS:
New-onset atrial arrhythmias are a frequent complication during VV-ECMO and are independently associated with excessive in-hospital mortality. Thus, their presence may serve as an important prognostic tool in this patient population.ключевые слова
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Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Thrombosis
/
Extracorporeal Membrane Oxygenation
Тип исследования:
Когортное исследование
/
Наблюдательное исследование
/
Прогностическое исследование
Пределы темы:
Люди
/
Мужчины
Язык:
английский
Журнал:
J Cardiothorac Vasc Anesth
Тематика журнала:
Анестезиология
/
Кардиология
Год:
2022
Тип:
Статья
Аффилированная страна:
J.jvca.2021.12.012
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