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Importance of pulse pressure after extracorporeal cardiopulmonary resuscitation
Author(s) -
Lee Seok In,
Lim Yong Su,
Park ChulHyun,
Choi Woo Sung,
Choi Chang Hyu
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15614
Subject(s) - medicine , extracorporeal membrane oxygenation , extracorporeal cardiopulmonary resuscitation , weaning , pulse pressure , extracorporeal , logistic regression , cardiopulmonary resuscitation , retrospective cohort study , resuscitation , univariate analysis , blood pressure , emergency medicine , anesthesia , cardiology , intensive care medicine , surgery , multivariate analysis
Background Recent reports have revealed better clinical outcomes for extracorporeal cardiopulmonary resuscitation (ECPR) than conventional cardiopulmonary resuscitation (CPR). In this retrospective study, we attempted to identify predictors associated with successful weaning off extracorporeal membrane oxygenation (ECMO) support after ECPR. Methods The demographic and clinical data of 30 ECPR patients aged over 18 years treated between August 2016 and January 2019 were analyzed. All clinical data were retrospectively collected. The primary endpoint was successful weaning off ECMO support after ECPR. Patients were divided into two groups based on successful or unsuccessful weaning off ECMO support (Weaned ( n = 14) vs. Failed ( n = 16)). Results Univariate logistic regression analysis showed that age, CPR duration, ECMO complications, and loss of pulse pressure significantly predicted the results of weaning off ECMO support. However, multivariate logistic regression analysis showed that only CPR duration and loss of pulse pressure independently predicted unsuccessful weaning from ECMO support. Conclusion We conclude that long CPR duration and loss of pulse pressure after ECPR predict unsuccessful weaning from ECMO. However, unlike CPR duration, loss of pulse pressure during post‐ECPR was related to subsequent management. In patients with reduced pulse pressure after ECPR, careful management is warranted because this reduction is closely associated with unsuccessful weaning off ECMO support after ECPR.