Early Hyperoxia and 28-Day Mortality in ...
Type de document :
Compte-rendu et recension critique d'ouvrage
Titre :
Early Hyperoxia and 28-Day Mortality in Patients on Venoarterial ECMO Support for Refractory Cardiogenic Shock: A Bicenter Retrospective Propensity Score-Weighted Analysis.
Auteur(s) :
Moussa, Mouhamed Djahoum [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Beyls, Christophe [Auteur]
CHU Amiens-Picardie
Lamer, Antoine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Roksic, Stefan [Auteur]
Juthier, Francis [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Leroy, Guillaume [Auteur]
Petitgand, Vincent [Auteur]
Rousse, Natacha [Auteur]
Institut Coeur Poumon [CHU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Decoene, Christophe [Auteur]
Dupré, Céline [Auteur]
Caus, Thierry [Auteur]
CHU Amiens-Picardie
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Huette, Pierre [Auteur]
Département d'anesthésiologie [CHU Caen]
Guilbart, Mathieu [Auteur]
CHU Amiens-Picardie
Guinot, Pierre-Grégoire [Auteur]
CHU Dijon
Besserve, Patricia [Auteur]
Mahjoub, Yazine [Auteur]
CHU Amiens-Picardie
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Dupont, Hervé [Auteur]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Robin, Emmanuel [Auteur]
Catalyse, Polymérisation, Procédés et Matériaux [CP2M]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Meynier, Jonathan [Auteur]
Direction de la recherche clinique et de l'innovation [CHU Amiens]
Vincentelli, André [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Abou-Arab, Osama [Auteur]
CHU Amiens-Picardie
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Beyls, Christophe [Auteur]
CHU Amiens-Picardie
Lamer, Antoine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Roksic, Stefan [Auteur]
Juthier, Francis [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Leroy, Guillaume [Auteur]
Petitgand, Vincent [Auteur]
Rousse, Natacha [Auteur]
Institut Coeur Poumon [CHU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Decoene, Christophe [Auteur]
Dupré, Céline [Auteur]
Caus, Thierry [Auteur]
CHU Amiens-Picardie
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Huette, Pierre [Auteur]
Département d'anesthésiologie [CHU Caen]
Guilbart, Mathieu [Auteur]
CHU Amiens-Picardie
Guinot, Pierre-Grégoire [Auteur]
CHU Dijon
Besserve, Patricia [Auteur]
Mahjoub, Yazine [Auteur]
CHU Amiens-Picardie
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Dupont, Hervé [Auteur]
Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC]
Robin, Emmanuel [Auteur]
Catalyse, Polymérisation, Procédés et Matériaux [CP2M]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Meynier, Jonathan [Auteur]
Direction de la recherche clinique et de l'innovation [CHU Amiens]
Vincentelli, André [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Abou-Arab, Osama [Auteur]
CHU Amiens-Picardie
Titre de la revue :
Critical Care
Pagination :
257
Éditeur :
BioMed Central
Date de publication :
2022
ISSN :
1364-8535
Mot(s)-clé(s) en anglais :
ECMO
Humans
Hyperoxia
Mortality
Oxygen
Propensity Score
Retrospective Studies
Shock
Cardiogenic
*Extracorporeal Membrane Oxygenation
*Hyperoxia
Adult
Cardiogenic shock
Humans
Hyperoxia
Mortality
Oxygen
Propensity Score
Retrospective Studies
Shock
Cardiogenic
*Extracorporeal Membrane Oxygenation
*Hyperoxia
Adult
Cardiogenic shock
Discipline(s) HAL :
Sciences du Vivant [q-bio]/Médecine humaine et pathologie
Résumé en anglais : [en]
BACKGROUND: The mortality rate for a patient with a refractory cardiogenic shock on venoarterial (VA) extracorporeal membrane oxygenation (ECMO) remains high, and hyperoxia might worsen this prognosis. The objective of the ...
Lire la suite >BACKGROUND: The mortality rate for a patient with a refractory cardiogenic shock on venoarterial (VA) extracorporeal membrane oxygenation (ECMO) remains high, and hyperoxia might worsen this prognosis. The objective of the present study was to evaluate the association between hyperoxia and 28-day mortality in this setting. METHODS: We conducted a retrospective bicenter study in two French academic centers. The study population comprised adult patients admitted for refractory cardiogenic shock. The following arterial partial pressure of oxygen (PaO(2)) variables were recorded for 48 h following admission: the absolute peak PaO(2) (the single highest value measured during the 48~h), the mean daily peak PaO(2) (the mean of each day's peak values), the overall mean PaO(2) (the mean of all values over 48~h), and the severity of hyperoxia (mild: PaO(2)\,<\,200~mmHg, moderate: PaO(2)\,=\,200-299~mmHg, severe: PaO(2)\,≥q\,300~mmHg). The main outcome was the 28-day all-cause mortality. Inverse probability weighting (IPW) derived from propensity scores was used to reduce imbalances in baseline characteristics. RESULTS: From January 2013 to January 2020, 430 patients were included and assessed. The 28-day mortality rate was 43%. The mean daily peak, absolute peak, and overall mean PaO(2) values were significantly higher in non-survivors than in survivors. In a multivariate logistic regression analysis, the mean daily peak PaO(2), absolute peak PaO(2), and overall mean PaO(2) were independent predictors of 28-day mortality (adjusted odds ratio [95% confidence interval per 10~mmHg increment: 2.65 [1.79-6.07], 2.36 [1.67-4.82], and 2.85 [1.12-7.37], respectively). After IPW, high level of oxygen remained significantly associated with 28-day mortality (OR\,=\,1.41 [1.01-2.08]; P\,=\,0.041). CONCLUSIONS: High oxygen levels were associated with 28-day mortality in patients on VA-ECMO support for refractory cardiogenic shock. Our results confirm the need for large randomized controlled trials on this topic.Lire moins >
Lire la suite >BACKGROUND: The mortality rate for a patient with a refractory cardiogenic shock on venoarterial (VA) extracorporeal membrane oxygenation (ECMO) remains high, and hyperoxia might worsen this prognosis. The objective of the present study was to evaluate the association between hyperoxia and 28-day mortality in this setting. METHODS: We conducted a retrospective bicenter study in two French academic centers. The study population comprised adult patients admitted for refractory cardiogenic shock. The following arterial partial pressure of oxygen (PaO(2)) variables were recorded for 48 h following admission: the absolute peak PaO(2) (the single highest value measured during the 48~h), the mean daily peak PaO(2) (the mean of each day's peak values), the overall mean PaO(2) (the mean of all values over 48~h), and the severity of hyperoxia (mild: PaO(2)\,<\,200~mmHg, moderate: PaO(2)\,=\,200-299~mmHg, severe: PaO(2)\,≥q\,300~mmHg). The main outcome was the 28-day all-cause mortality. Inverse probability weighting (IPW) derived from propensity scores was used to reduce imbalances in baseline characteristics. RESULTS: From January 2013 to January 2020, 430 patients were included and assessed. The 28-day mortality rate was 43%. The mean daily peak, absolute peak, and overall mean PaO(2) values were significantly higher in non-survivors than in survivors. In a multivariate logistic regression analysis, the mean daily peak PaO(2), absolute peak PaO(2), and overall mean PaO(2) were independent predictors of 28-day mortality (adjusted odds ratio [95% confidence interval per 10~mmHg increment: 2.65 [1.79-6.07], 2.36 [1.67-4.82], and 2.85 [1.12-7.37], respectively). After IPW, high level of oxygen remained significantly associated with 28-day mortality (OR\,=\,1.41 [1.01-2.08]; P\,=\,0.041). CONCLUSIONS: High oxygen levels were associated with 28-day mortality in patients on VA-ECMO support for refractory cardiogenic shock. Our results confirm the need for large randomized controlled trials on this topic.Lire moins >
Langue :
Anglais
Vulgarisation :
Non
Source :
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