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Table 1 Patient baseline characteristics

From: Microcirculatory assessment of patients under VA-ECMO

Demographics

Total (n = 24)

Survivors (n = 15)

Non-survivors (n = 9)

P valuea

Age (years)

56 (20–70)

51 (23–70)

51 (20–67)

0.244

Male gender (n (%))

16 (67)

12 (80)

4 (44)

0.08

BMI (kg/m2)

24.5 (19–37)

25.0 (19–37)

24.0 (20–37)

0.904

SOFA score on admission day

11 (2–20)

10 (4–20)

12 (2–15)

0.309

APACHE II

32 (19–45)

31 (19–45)

34 (29–44)

0.244

VA-ECMO indications

 Dilated cardiomyopathy

1

0

1

ns

 Ischemic cardiomyopathy

2

1

1

ns

 Fulminant myocarditis

1

0

1

ns

 Intoxication

1

1

0

ns

 Pulmonary embolism

1

1

1

ns

 Drowning

1

1

0

ns

 Post-cardiectomy

5

4

1

ns

 Cardiac arrest (n (%))

12 (50)

8

4

0.680

  IHCA

4

3

1

 

  OHCA

8

5

3

Global hemodynamics at admission

 Heart rate (beats/min)

93 (50–185)

91 (50–128)

95 (64–185)

0.858

 MAP (mmHg)

67 (15–103)

71 (49–98)

66 (15–103)

0.269

 Lactate (mmol/L)

4.1 (1.1–26)

4.0 (1.20–26)

6.2 (1.1–18)

0.743

 Hb (mmol/L)

6.0 (4.7–11.3)

6.2 (4.7–11.30)

5.7 (5.0–7.9)

0.152

 Htc (L/L)

0.32 (0.23–0.50)

0.30 (0.27–0.50)

0.28 (0.23–0.39)

0.100

 Platelet count (1000/mm3)

136 (18–336)

136 (64–336)

148 (18–227)

0.835

 LDH (U/L)

888 (264–16,779)

810 (264–16,779)

973 (360–3863)

0.493

 Free-Hb (mg/dl)

4 (1–640)

4 (1.0–640)

4 (1.0–17)

0.516

 HsTnT (ng/L)

4657 (45–89,641)

1683 (45–42,813)

13,369 (215–89,641)

0.030

 CK (U/L)

2771 (27–18,526)

1082 (223–7286)

2637 (27–18,526)

0.114

 CKMB (μg/L)

45.8 (1.2–859)

36.9 (2.5–412.1)

226 (1.2–859)

0.233

VA-ECMO flow (L/min)

4.14 (2.40–6.30)

4.0 (2.40–6.30)

4.1 (3.30–4.70)

0.929

Timing between VA-ECMO insertion and first microcirculation measurement (h)

15 (1–22)

15 (2–22)

13 (1–21)

0.857

Timing between VA-ECMO insertion and first echocardiography measurement (h)

9 (1–23)

7 (1–23)

11 (3–21)

0.426

Echocardiographic parameter at first 24 h after VA-ECMO implantation

 Aortic VTI (cm)

7 (5–22)

8,5 (5–22)

6 (5–12)

0.220

 LVEF (%)

15 (7–55)

20 (8–55)

10 (7–20)

0.010

 TDSab (cm/s)

5 (5–7)

5 (5–7)

5.5 (5–6)

1

 TAPSE (cm)

10 (8–20)

10 (8–15)

8 (8–20)

0.845

Global hemodynamic parameters at first 24 h after VA-ECMO implantation

 COc (L/min)

2.1 (0.75–5.73)

2.46 (0.75–5.73)

1.37 (0.97–4.0)

0.035

 CId (L/min/m2)

1.1 (0.39–2.81)

1.23 (0.39–2.81)

0.74 (0.48–1.69)

0.069

 DO2 e (ml O2/min)

289 (122–790)

327 (150–790)

174 (122–510)

0.006

 Fluid balance

1.35 (–1.90 to 4.00)

1.50 (–1.90 to 3.80)

1.0 (–1.10 to 4.0)

0.590

 CVP (mmHg)

12 (1–32)

12 (1–32)

12 (5–17)

0.726

Microcirculation at first 24 h after VA-ECMO implantation

 All

 TVD (mm/mm2)

17.13 (11.88–30.39)

20.07 (15.71–30.39)

14.92 (11.88–23.99)

0.008

 PVD (mm/mm2)

16.32 (11.01–29.60)

19.21 (12.99–29.60)

13.78 (11.01–18.47)

0.001

 PPV (%)

96.48 (76.99–100)

98.06 (76.99–100)

89.20 (77–100)

0.044

 MFI (AU)

2.97 (1.75–3.0)

3.0 (2.50–3.0)

2.87 (1.75–3.0)

0.191

Small

 TVD (mm/mm2)

15.70 (10.91–29.62)

18.85 (12.80–29.62)

11.84 (10.91–20.32)

0.009

 PVD (mm/mm2)

14.16 (9.80–28.23)

18.61 (9.80–28.83)

11.01 (10.13–16.89)

0.003

 PPV (%)

96.45 (43.59–100)

97.97 (76.46–100)

89.77 (82.93–100)

0.038

 MFI (AU)

3 (0.75–3.0)

3.0 (2.25–3.0)

3.0 (0.75–3.0)

0.084

Outcome

 Total days on VA-ECMO (days)

5.5 (2–36)

6 (2–21)

5 (2–36)

0.588

 ICU length of stay (days)

13.5 (2–65)

18 (6–65)

5 (2–36)

0.03

 VA-ECMO-free days on ICU (days)

2.5 (0–52)

10 (0–52)

0

0.0000

 Hospital length of stay (days)

17 (2–72)

22 (6–72)

5 (2–36)

0.01

 ICU mortality (n (%))

9 (37.5)

0

9

 

 Hospital mortality (n (%))

11 (45.8)

2

9

 
  1. Categorical variables are presented as frequencies and percentages (n (%)) where stated; all other (continuous) variables are presented as median (range)
  2. APACHE Acute Physiology and Chronic Health Evaluation, AU arbitrary units, BMI body mass index, BSA body surface area, CI cardiac index, CK creatine kinase, CK-MB myoglobin fraction of creatine kinase, CO cardiac output, CVP central venous pressure, DO 2 oxygen delivery, free-Hb free hemoglobin, Hb hemoglobin, HsTnT high sensitive troponin T, Htc haematocrit, ICU intensive care unit, IHCA in-hospital cardiac arrest, LDH lactate dehydrogenase, LVEF left ventricular ejection fraction, LVOT left ventricular outflow tract, MAP mean arterial pressure, MFI microvascular flow index, OHCA out-of-hospital cardiac arrest, PaO 2 arterial oxygen tension, PPV portion of perfused vessels, PVD perfused vessel density, SaO 2 arterial oxygen saturation, SOFA Sequential Organ Failure Assessment, TAPSE Tricuspid annular plane systolic excursion, TDSa spectral tissue Doppler imaging mitral annulus peak systolic velocity, TVD total vessel density, VA-ECMO veno-arterial extracorporeal membrane oxygenation, VTI velocity time integral
  3. aA Mann Whitney U test was used for comparison between the survivor and non-survivor groups; significant results are shown in bold text
  4. bTDSa was only retrospectively found in 7 of the 24 patients’ echocardiography
  5. cCO = heart rate × stroke volume, where stroke volume = LVOT area × LVOT VTI, and LVOT area was calculated by two-dimensional echocardiography using the following formula: (π × (LVOT diameter/2)2 (45)
  6. dCI = CO/BSA, where BSA (in m2) was calculated according to the formula (by DuBois and DuBois) BSA = 0.20247 × height (m)0.725 × weight (kg)0.425
  7. eDO2 = CO × CaO2 × 10, where CaO2 = (Hb × 1.34 × SaO2) + (PaO2 × 0.003); 0.003 is the solubility coefficient of oxygen in human plasma; each gram of hemoglobin is capable of carrying 1.34 mL of oxygen, and the amount of oxygen carried on the haemoglobin is Hb × 1.34 × SaO2
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Critical Care

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