Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation

OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those pati...

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Autores principales:	Clemens Scherer, MD, Enzo Lüsebrink, MD, Dominik Joskowiak, MD, Vanessa Feuchtgruber, MDS, Tobias Petzold, MD, Jörg Hausleiter, MD, Sven Peterss, MD, Steffen Massberg, MD, Christian Hagl, MD, Martin Orban, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/d1c014da5552466a9e94a987c7855e5a
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spelling	oai:doaj.org-article:d1c014da5552466a9e94a987c7855e5a2021-11-25T07:56:43ZMortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation2639-802810.1097/CCE.0000000000000540https://doaj.org/article/d1c014da5552466a9e94a987c7855e5a2021-10-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000540https://doaj.org/toc/2639-8028OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those patients. DESIGN:. Observational, monocentric, retrospective analysis. SETTING:. Cardiac ICU of Ludwig Maximilian University Hospital, Munich, Germany. PATIENTS:. Two-hundred eleven patients undergoing venoarterial extracorporeal membrane oxygenation treatment for severe cardiogenic shock were included into this analysis. Patients who died within 24 hours after venoarterial extracorporeal membrane oxygenation implantation were excluded. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. To determine lung injury, we investigated the influence of Pao2/Fio2 ratio (Horowitz index). The lowest Horowitz index was measured on ICU 6–12 hours after venoarterial extracorporeal membrane oxygenation implantation. An optimal cutoff value of less than 126 for Horowitz index to predict mortality was identified via receiver operating characteristic analysis (area under the curve, 0.62). Patients with Horowitz index less than 126 had a 30-day mortality rate of 67.5% compared to 37.5% with a Horowitz index greater than or equal to 126 (p < 0.001). Multivariate analysis identified Horowitz index less than 126 as an independent risk factor of ICU mortality (odds ratio, 3.6; 95% CI, 1.8–7.3; p < 0.001). CONCLUSIONS:. In this hypothesis-generating analysis, a Horowitz index less than 126 is associated with increased mortality in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation, which may serve as a threshold for further therapeutic interventions.Clemens Scherer, MDEnzo Lüsebrink, MDDominik Joskowiak, MDVanessa Feuchtgruber, MDSTobias Petzold, MDJörg Hausleiter, MDSven Peterss, MDSteffen Massberg, MDChristian Hagl, MDMartin Orban, MDWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 10, p e0540 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
description	OBJECTIVES:. Venoarterial extracorporeal membrane oxygenation treatment in patients with severe cardiogenic shock can cause or aggravate acute lung injury. In our retrospective analysis, we aimed at identifying markers for acute lung injury after arrival on ICU, which predict mortality of those patients. DESIGN:. Observational, monocentric, retrospective analysis. SETTING:. Cardiac ICU of Ludwig Maximilian University Hospital, Munich, Germany. PATIENTS:. Two-hundred eleven patients undergoing venoarterial extracorporeal membrane oxygenation treatment for severe cardiogenic shock were included into this analysis. Patients who died within 24 hours after venoarterial extracorporeal membrane oxygenation implantation were excluded. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. To determine lung injury, we investigated the influence of Pao2/Fio2 ratio (Horowitz index). The lowest Horowitz index was measured on ICU 6–12 hours after venoarterial extracorporeal membrane oxygenation implantation. An optimal cutoff value of less than 126 for Horowitz index to predict mortality was identified via receiver operating characteristic analysis (area under the curve, 0.62). Patients with Horowitz index less than 126 had a 30-day mortality rate of 67.5% compared to 37.5% with a Horowitz index greater than or equal to 126 (p < 0.001). Multivariate analysis identified Horowitz index less than 126 as an independent risk factor of ICU mortality (odds ratio, 3.6; 95% CI, 1.8–7.3; p < 0.001). CONCLUSIONS:. In this hypothesis-generating analysis, a Horowitz index less than 126 is associated with increased mortality in patients with cardiogenic shock and venoarterial extracorporeal membrane oxygenation, which may serve as a threshold for further therapeutic interventions.
format	article
author	Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD
author_facet	Clemens Scherer, MD Enzo Lüsebrink, MD Dominik Joskowiak, MD Vanessa Feuchtgruber, MDS Tobias Petzold, MD Jörg Hausleiter, MD Sven Peterss, MD Steffen Massberg, MD Christian Hagl, MD Martin Orban, MD
author_sort	Clemens Scherer, MD
title	Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
title_short	Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
title_full	Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
title_fullStr	Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
title_full_unstemmed	Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation
title_sort	mortality in cardiogenic shock patients is predicted by pao2/fio2 (horowitz index) measured on icu after venoarterial extracorporeal membrane oxygenation implantation
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/d1c014da5552466a9e94a987c7855e5a
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Mortality in Cardiogenic Shock Patients Is Predicted by Pao2/Fio2 (Horowitz Index) Measured on ICU After Venoarterial Extracorporeal Membrane Oxygenation Implantation

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