Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those pati...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2021-10-01
|
| Series: | Critical Care Explorations |
| Online Access: | http://journals.lww.com/10.1097/CCE.0000000000000540 |
| _version_ | 1818987130130530304 |
|---|---|
| author | Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD |
| author_facet | Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD |
| author_sort | Clemens Scherer, MD |
| collection | DOAJ |
| description | OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those patients.
DESIGN:. Observational, monocentric, retrospective analysis.
SETTING:. Cardiac ICU of Ludwig Maximilian University Hospital, Munich, Germany.
PATIENTS:. Two-hundred eleven patients undergoing venoarterial extracorporeal membrane oxygenation treatment for severe cardiogenic shock were included into this analysis. Patients who died within 24 hours after venoarterial extracorporeal membrane oxygenation implantation were excluded.
INTERVENTIONS:. None.
MEASUREMENTS AND MAIN RESULTS:. To determine lung injury, we investigated the influence of Pao2/Fio2 ratio (Horowitz index). The lowest Horowitz index was measured on ICU 6–12 hours after venoarterial extracorporeal membrane oxygenation implantation. An optimal cutoff value of less than 126 for Horowitz index to predict mortality was identified via receiver operating characteristic analysis (area under the curve, 0.62). Patients with Horowitz index less than 126 had a 30-day mortality rate of 67.5% compared to 37.5% with a Horowitz index greater than or equal to 126 (p < 0.001). Multivariate analysis identified Horowitz index less than 126 as an independent risk factor of ICU mortality (odds ratio, 3.6; 95% CI, 1.8–7.3; p < 0.001).
CONCLUSIONS:. In this hypothesis-generating analysis, a Horowitz index less than 126 is associated with increased mortality in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation, which may serve as a threshold for further therapeutic interventions. |
| first_indexed | 2024-12-20T19:01:47Z |
| format | Article |
| id | doaj.art-d1c014da5552466a9e94a987c7855e5a |
| institution | Directory Open Access Journal |
| issn | 2639-8028 |
| language | English |
| last_indexed | 2024-12-20T19:01:47Z |
| publishDate | 2021-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Critical Care Explorations |
| spelling | doaj.art-d1c014da5552466a9e94a987c7855e5a2022-12-21T19:29:23ZengWolters KluwerCritical Care Explorations2639-80282021-10-01310e054010.1097/CCE.0000000000000540202110000-00001Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation ImplantationClemens Scherer, MD0Enzo Lüsebrink, MD1Dominik Joskowiak, MD2Vanessa Feuchtgruber, MDS3Tobias Petzold, MD4Jörg Hausleiter, MD5Sven Peterss, MD6Steffen Massberg, MD7Christian Hagl, MD8Martin Orban, MD91 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.3 Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.3 Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.3 Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany.1 Department of Medicine I, University Hospital, LMU Munich, Munich, Germany.OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those patients. DESIGN:. Observational, monocentric, retrospective analysis. SETTING:. Cardiac ICU of Ludwig Maximilian University Hospital, Munich, Germany. PATIENTS:. Two-hundred eleven patients undergoing venoarterial extracorporeal membrane oxygenation treatment for severe cardiogenic shock were included into this analysis. Patients who died within 24 hours after venoarterial extracorporeal membrane oxygenation implantation were excluded. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. To determine lung injury, we investigated the influence of Pao2/Fio2 ratio (Horowitz index). The lowest Horowitz index was measured on ICU 6–12 hours after venoarterial extracorporeal membrane oxygenation implantation. An optimal cutoff value of less than 126 for Horowitz index to predict mortality was identified via receiver operating characteristic analysis (area under the curve, 0.62). Patients with Horowitz index less than 126 had a 30-day mortality rate of 67.5% compared to 37.5% with a Horowitz index greater than or equal to 126 (p < 0.001). Multivariate analysis identified Horowitz index less than 126 as an independent risk factor of ICU mortality (odds ratio, 3.6; 95% CI, 1.8–7.3; p < 0.001). CONCLUSIONS:. In this hypothesis-generating analysis, a Horowitz index less than 126 is associated with increased mortality in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation, which may serve as a threshold for further therapeutic interventions.http://journals.lww.com/10.1097/CCE.0000000000000540 |
| spellingShingle | Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation Critical Care Explorations |
| title | Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation |
| title_full | Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation |
| title_fullStr | Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation |
| title_full_unstemmed | Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation |
| title_short | Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation |
| title_sort | mortality in cardiogenic shock patients is predicted by pao2 fio2 horowitz index measured on icu after venoarterial extracorporeal membrane oxygenation implantation |
| url | http://journals.lww.com/10.1097/CCE.0000000000000540 |
| work_keys_str_mv | AT clemensscherermd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT enzolusebrinkmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT dominikjoskowiakmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT vanessafeuchtgrubermds mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT tobiaspetzoldmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT jorghausleitermd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT svenpeterssmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT steffenmassbergmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT christianhaglmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation AT martinorbanmd mortalityincardiogenicshockpatientsispredictedbypao2fio2horowitzindexmeasuredonicuaftervenoarterialextracorporealmembraneoxygenationimplantation |