• Journal of critical care · Feb 2017

    Early fluid resuscitation and volume therapy in venoarterial extracorporeal membrane oxygenation.

    • Dawid L Staudacher, Wolfgang Gold, Paul M Biever, Christoph Bode, and Tobias Wengenmayer.
    • Department of Cardiology and Angiology I, Heart Center Freiburg University, Germany. Electronic address: dawid.staudacher@universitaets-herzzentrum.de.
    • J Crit Care. 2017 Feb 1; 37: 130-135.

    PurposeFor circulatory support, venoarterial extracorporeal membrane oxygenation (VA-ECMO) is dependent on sufficient venous drainage ensured by fluid therapy. Volume overload however is linked to poor prognosis. This study therefore evaluates volume therapy in VA-ECMO.Material And MethodsWe report data of a single center registry of all patients after VA-ECMO implantation treated between 2010 and 2015.ResultsA total of 195 patients were included in this registry with a medium age of 58.2 ± 1.1 years, 71.8% were male. A positive fluid balance was detected in 94.7% at day 1 (day 2: 93.7%, day 3: 92.6%). Consistently, survivors had a lower fluid balance when compared to non-survivors (P < .001). Three hours post-implantation, patients above the 75th percentile had a hazard ratio of 6.03 when compared to average survival (P < .05). AUC at that time point was 0.726 as calculated by ROC. Patients below the 50th percentile (fluid balance below 8500 mL after 24 hours) had the best prognosis after VA-ECMO implantation (P < .001).ConclusionsHigher fluid balance was consistently linked to poor survival. We found no evidence to support a liberal fluid therapy in VA-ECMO patients, especially not the early after implantation. With a retrospective study, one cannot clarify if lower fluid balance might improve outcomes or represents a prognostic marker.Copyright © 2016 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.