Predicting Parameters for Successful Weaning from Veno‐Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock

• DOI: 10.1002/ehf2.13097
• Publication Date: 2020-12-02T22:27:40Z
• Authors: Kenichiro Sawada; Shoji Kawakami; Shunsuke Murata; Kunihiro Nishimura; Yoshio Tahara; Hayato Hosoda; Takahiro Nakashima; Yu Kataoka; Yasuhide Asaumi; Teruo Noguchi; Masaru Sugimachi; Tomoyuki Fujita; Junjiro Kobayashi; Satoshi Yasuda
• Keywords: Pulmonary wedge pressure; Pulmonary artery catheter

Percutaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is utilized for patients with cardiogenic shock or cardiac arrest. However, the procedure protocol weaning from VA-ECMO has not been well established. The present study aimed to determine usefulness of echocardiographic and pulmonary artery catheter parameters predicting successful in refractory shock.We retrospectively studied 50 who were hospitalized supported by >48 h between January 2013 March 2017. Patients successfully weaned without reintroduction left ventricular assist device implantation defined as 30 day survivors. Echocardiographic evaluated when ECMO flow was limited a maximum 1.5-2.0 L/min. Twenty-four VA-ECMO, whereas 26 not. Fractional shortening, corrected ejection time (LVETc, LVET divided square root heart rate), outflow tract velocity integral, LVETc wedge pressure (PAWP) significantly larger survivor groups. Multivariable analysis revealed LVETc∕PAWP significant independent predictor (LVETc∕PAWP, odds ratio 0.82, 95% confidence interval 0.71-0.94, P = 0.005). Receiver operating characteristic curve 15.9 optimal (area under 0.82).The findings indicate that potential VA-ECMO.