dc.contributor.author | Kara, Atila | |
dc.contributor.author | Akin, Sakir | |
dc.contributor.author | dos Reis Miranda, Dinis | |
dc.contributor.author | Struijs, Ard | |
dc.contributor.author | Caliskan, Kadir | |
dc.contributor.author | van Thiel, Robert J. | |
dc.contributor.author | Dubois, Eric A. | |
dc.contributor.author | de Wilde, Wouter | |
dc.contributor.author | Zijlstra, Felix | |
dc.contributor.author | Gommers, Diederik | |
dc.contributor.author | Ince, Can | |
dc.date.accessioned | 2019-12-10T11:14:56Z | |
dc.date.available | 2019-12-10T11:14:56Z | |
dc.date.issued | 2016 | |
dc.identifier.issn | 1364-8535 | |
dc.identifier.uri | https://doi.org/10.1186/s13054-016-1519-7 | |
dc.identifier.uri | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5078964/ | |
dc.identifier.uri | http://hdl.handle.net/11655/15185 | |
dc.description.abstract | Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an effective technique for providing emergency mechanical circulatory support for patients with cardiogenic shock. VA-ECMO enables a rapid restoration of global systemic organ perfusion, but it has not been found to always show a parallel improvement in the microcirculation. We hypothesized in this study that the response of the microcirculation to the initiation of VA-ECMO might identify patients with increased chances of intensive care unit (ICU) survival. Methods Twenty-four patients were included in this study. Sublingual microcirculation measurements were performed using the CytoCam-IDF (incident dark field) imaging device. Microcirculatory measurements were performed at baseline, after VA-ECMO insertion (T1), 48–72 h after initiation of VA-ECMO (T2), 5–6 days after (T3), 9–10 days after (T4), and within 24 h of VA-ECMO removal. Results Of the 24 patients included in the study population, 15 survived and 9 died while on VA-ECMO. There was no significant difference between the systemic global hemodynamic variables at initiation of VA-ECMO between the survivors and non-survivors. There was, however, a significant difference in the microcirculatory parameters of both small and large vessels at all time points between the survivors and non-survivors. Perfused vessel density (PVD) at baseline (survivor versus non-survivor, 19.21 versus 13.78 mm/mm2, p = 0.001) was able to predict ICU survival on initiation of VA-ECMO; the area under the receiver operating characteristic curve (ROC) was 0.908 (95 % confidence interval 0.772–1.0). Conclusion PVD of the sublingual microcirculation at initiation of VA-ECMO can be used to predict ICU mortality in patients with cardiogenic shock. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1519-7) contains supplementary material, which is available to authorized users. | |
dc.relation.isversionof | 10.1186/s13054-016-1519-7 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.title | Microcirculatory Assessment Of Patients Under Va-Ecmo | |
dc.type | info:eu-repo/semantics/article | |
dc.relation.journal | Critical Care | |
dc.contributor.department | İç Hastalıkları | |
dc.identifier.volume | 20 | |
dc.description.index | PubMed | |
dc.description.index | WoS | |
dc.description.index | Scopus | |