Percutaneous versus surgical femoro-femoral veno-arterial ECMO: a propensity score matched study

Danial, Pichoy; Hajage, David; Nguyen, Lee S.; Mastroianni, Ciro; Demondion, Pierre; Schmidt, Matthieu; Bouglé, Adrien; Amour, Julien; Leprince, Pascal; Combes, Alain; Lebreton, Guillaume

doi:10.1007/s00134-018-5442-z

Cited by 135 publications

(93 citation statements)

References 36 publications

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“…Haemolysis and increased load of filtered pigment (e.g. myoglobin, CK) may result from muscle damage due to local ischaemia during ECMO [31,110]. Also, raised levels of proinflammatory cytokines (e.g.…”

Section: Rationalementioning

confidence: 99%

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

et al. 2019

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Background: Multi-organ dysfunction in critical illness is common and frequently involves the lungs and kidneys, often requiring organ support such as invasive mechanical ventilation (IMV), renal replacement therapy (RRT) and/or extracorporeal membrane oxygenation (ECMO). Methods:A consensus conference on the spectrum of lung-kidney interactions in critical illness was held under the auspices of the Acute Disease Quality Initiative (ADQI) in Innsbruck, Austria, in June 2018. Through review and critical appraisal of the available evidence, the current state of research, and both clinical and research recommendations were described on the following topics: epidemiology, pathophysiology and strategies to mitigate pulmonary dysfunction among patients with acute kidney injury and/or kidney dysfunction among patients with acute respiratory failure/acute respiratory distress syndrome. Furthermore, emphasis was put on patients receiving organ support (RRT, IMV and/or ECMO) and its impact on lung and kidney function. Conclusion:The ADQI 21 conference found significant knowledge gaps about organ crosstalk between lung and kidney and its relevance for critically ill patients. Lung protective ventilation, conservative fluid management and early recognition and treatment of pulmonary infections were the only clinical recommendations with higher quality of evidence. Recommendations for research were formulated, targeting lung-kidney interactions to improve care processes and outcomes in critical illness.

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Section: Rationalementioning

confidence: 99%

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

et al. 2019

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“…There is weak evidence suggesting an increased risk of infection with central cannulation and a decreased risk with single-site, dual-lumen cannulae [7,38]. In a recent single-center propensity score-matched analysis of 814 patients undergoing venoarterial ECLS, cannula site infections were significantly more common with a surgical approach than a percutaneous approach (27.8% vs 16.5%, p < 0.001) [40]. Historical data suggest an increased incidence of bloodstream infections in ECLS patients compared with non-ECLS critically ill patients [41], although this has not been corroborated in the era of modern ECLS technology and practices.…”

Section: Risk Factors For the Development Of Infections During Eclsmentioning

confidence: 99%

ECLS-associated infections in adults: what we know and what we don’t yet know

et al. 2019

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Extracorporeal life support (ECLS) is increasingly used in the management of patients with severe cardiopulmonary disease. Infections are frequently the etiologies underlying the respiratory, and occasionally cardiac, failure that necessitates ECLS. Just as importantly, infections are among the most commonly reported adverse events during ECLS. Infections in this setting may be the sequelae of prolonged critical illness or of underlying immune dysregulation; they may be hospital-acquired infections, and they may or may not be attributable to the presence of ECLS itself, the latter being an aspect that can be difficult to determine. Current registry data and evidence from the literature offer some insights, but also leave open many questions regarding the nature and significance of infections reported both before and during ECLS, including the question of any causal link between ECLS and the development of infections. An ongoing lack of consistency in the identification, diagnosis, management, and prevention of infections during ECLS is limiting our ability to interpret literature data and thus highlighting the need for more rigorous investigation and standardization of definitions. This review aims to characterize the current understanding of infections associated with the use of ECLS, taking into account data from the updated Extracorporeal Life Support Organization Registry, which provides important context for understanding the epidemiology and outcomes of these patients.

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“…All statistical analyses were conducted using the SPSS (Statistical Package for Social Sciences) 22.0 software (IBM, Armonk, NY, USA) with a R software -plug-ins (R-2.15.3, https://cran.r-project.org/bin/windows/base/ old/) [20,21]. Statistical tests were considered significant at P < 0.05 (two-sided).…”

Section: Statistical Analysesmentioning

confidence: 99%

Impact of initial dialysis modality on the survival of patients with ESRD in eastern China: a propensity-matched study

et al. 2020

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Background: There are conflicting research results about the survival differences between hemodialysis(HD) and peritoneal dialysis (PD). The present study estimated the survival and the relative mortality hazard for incident HD and PD patients with end stage renal disease (ESRD) in eastern China. Methods: This study examined a cohort of patients with ESRD who initiated dialysis therapy in Zhejiang province between Jan of 2010 and Dec of 2014, followed up until the end of 2015. PD patients were matched in a 1:1 fashion with HD patients, and Kaplan-Meier analysis was used to explore the survival of them. The Cox proportional hazard regression model was applied to identify the factors that predict survival by treatment modality. Subgroup analyses were conducted by stratifying patients according to gender, age, causes of ESRD and comorbidities. Results: Among a total of 22,379 enrolled patients (17,029 HD patients and 5350 PD patients), 5350 matched pairs were identified, and followed for a median of 29 months (3~72 months). Kaplan-Meier survival curve revealed that overall mortality rate was significantly higher in HD patients than in PD patients (log-rank test, P < 0.001), after adjusting by gender, age, primary causes of ESRD and comorbidities. HD was consistently associated with an increased risk for morality compared with PD in the matched cohort (adjusted hazard ratio (AHR): 1.140, 95%CI: 1.023~1.271). In subgroup analyses, male, younger patients, or nondiabetic patients aged less than 65 years after adjustment of covariates, initiating with PD was associated with a significantly lower mortality compared with HD. In the multivariate Cox proportional risks model, age, diabetic nephropathy (DN), other/unknown causes of ESRD, and patients with a history of cardiovascular disease or cancer showed statistical significance in explaining survival of incident ESRD patients. Conclusions: ESRD patients who initiated dialysis with PD yielded superior survival rates compared to HD. Increased use of PD as initial dialysis modality in ESRD patients could be encouraged in Chinese population.

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Percutaneous versus surgical femoro-femoral veno-arterial ECMO: a propensity score matched study

Cited by 135 publications

References 36 publications

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

ECLS-associated infections in adults: what we know and what we don’t yet know

Impact of initial dialysis modality on the survival of patients with ESRD in eastern China: a propensity-matched study

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