Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-045
Clinical Predictors of Successful Weaning VA-ECMO
By Sheng-Fu Liu, Chih Yu Hsu, Chih Kuo Lee, Hsien-Li Kao
Presenter
Chih Yu Hsu
Authors
Sheng-Fu Liu1, Chih Yu Hsu2, Chih Kuo Lee3, Hsien-Li Kao2
Affiliation
National Taiwan University Hospital Hsin-Chu Branch, Taiwan1, National Taiwan University Hospital, Taiwan2, Ntuh Hsin-Chu Branch, Taiwan3
View Study Report
TCTAP A-045
Hemodynamic Support and Cardiogenic Shock
Clinical Predictors of Successful Weaning VA-ECMO
Sheng-Fu Liu1, Chih Yu Hsu2, Chih Kuo Lee3, Hsien-Li Kao2
National Taiwan University Hospital Hsin-Chu Branch, Taiwan1, National Taiwan University Hospital, Taiwan2, Ntuh Hsin-Chu Branch, Taiwan3
Background
Extracorporeal membrane oxygenation (ECMO) has been used clinically for more than fifty years. It played an important role in patients with cardiogenic shock state. ECMO has been successfully used as a bridge to myocardial recovery. If myocardial injury couldn’t be recovered, it could be as a bridge to definite therapies, like cardiac transplantation, or implantation of a ventricular assist device (VAD). To date, there is no study which was specifically designed to predict which patients can be successfully weaned off ECMO. Besides, there was either no standard weaning procedure currently. This study objectives are to test daily clinical parameters, which are associated with successfully ECMO weaning.
Methods
We reviewed and collected the patients’ clinically data, at the time of ECMO onset in NTUH HC branch retrospectively, in 2010 ~ 2017. The following data were recorded: baseline characteristics, indication for ECMO, ECMO durations, serious complications, blood routine and biochemistry, urine output, hemodynamic parameters (blood pressure, pulse pressure, central venous pressure, heart rate) , heart rhythm, inotropine equivalent, echocardiographic parameters. Blood routine and biochemistry includes CBC, liver and renal function, lactate, lactate clearance, arterial gas analysis, PaO2 / FiO2 ratio, peak CK/CKMB/Troponin-T level, etc.
Results
35 subjects had been collected in this project. There were 24 cases in successful weaning group, and 11 in weaning failure group. Demographic information and clinical conditions were no significant difference between both of the groups. The possible weaning predictors were BSA (HR 65.17, 95% CI 3.01-1412.04, p = 0.008)、Chronic lung disease (HR 0.1, 95% CI 0.01-0.78, p = 0.02)、Atrial fibrillation (HR 0.33, 95%CI = 0.12-0.92, p = 0.03)、CVP level (HR = 0.89, 95% CI 0.8-0.99, p = 0.03)、Heart rate (HR 0.95, 95% CI 0.92-0.99, p = 0.007)、Peak T-bil (HR 0.92, 95% CI = 0.85-0.99, p = 0.05) by univariate analysis. The only independent predictor was heart rate on the day with the first intent of decannulation of VA-ECMO after multivariate analysis (HR 0.95, 95% CI 0.91-0.99, p = 0.029).
Conclusion
In conclusion, heart rate on the day with the first intent of decannulation of Veno-arterial-Extracorporeal membrane oxygenation (VA-ECMO) can predict better successful decannulation.