Total cholesterol and Intensive Care survival in patients treated with Veno-Arterial Extracorporeal Life Support; A preliminary single-centre experience

Abstract

Objective Veno-Arterial Extra Corporeal Life Support (VA ECLS) is widely used as an effective device for patients in cardiogenic shock. The need for predictive markers that daily guide physicians in the evaluation of these patients could be of great value. Our aim was to investigate the role of cholesterol value during VA ECLS in predicting the Intensive Care Unit (ICU) survival. Methods Between January 2013 and November 2019, 67 patients with VA ECLS due to cardiogenic shock were included in this study. Demographic data, laboratory values, ICU data and outcomes were collected. Cholesterol was measured during morning routine blood samples. The minimal cholesterol value during the ICU stay was registered. Groups were stratified by minimal cholesterol cut-off point of 2.0 mmol/L. Logistic regression analysis were performed to identify variables associated with ICU survival. Results The ECLS duration was not significantly different (p=0.36) between the non-survivors (median 5.0 (2.0-7.5) days) and survivors (median 6.0 (1.8-12.0) days). The minimal cholesterol level was significantly lower (p=0.04) in non-survivors group (1.54 (1.00-1.87) mmol/L) compared to survivors (1.85 (1.38-2.24) mmol/L). By using logistic regression analysis, minimal cholesterol level of ≥2.0 mmol/L was associated with a higher ICU survival (p=0.02; OR 3.77; 95% CI 1.20-11.81). Conclusion Cholesterol level could be an additional marker for ICU survival of patients with cardiogenic shock on VA ECLS. A larger cohort of patients is necessary to determine total cholesterol as a specific risk factor for survival in these patients.