Abstract 14792: Usefulness of Echocardiographic Parameters for Predicting Successful Weaning From Percutaneous Veno-arterial Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock or Cardiac Arrest
Introduction: Recent studies show percutaneous veno-arterial extracorporeal membrane oxygenation (ECMO) is effective for surviving from cardiac arrest or cardiogenic shock. However, the proper protocol weaning from ECMO has not been well-established.
Hypothesis: We assessed the hypothesis that echocardiographic parameters including LV ejection time (LVET) and LV outflow tract velocity time integral (VTI), which were associated with stroke volume, would be potential predictors for successfully weaning from ECMO.
Methods: We studied 43 patients supported by ECMO [69 (56-78) years old, 28 men (65%)] between January 2014 and December 2015. Successful weaning was defined as 72-hour survival without re-introduction of ECMO after discontinuation of mechanical support. LVETc, LVET divided by the square root of heart rate, and VTI were evaluated when ECMO flow was 1.8-2.0 L/min. If ECMO flow could not decreased to this level, the maximum value of these parameters were used for the analysis.
Results: Twenty-four patients were successfully weaned from ECMO, while 19 patients were not. There were no significant differences in age, gender, indication or duration of ECMO, and laboratory tests between the groups. LVETc [259 (226-308) ms] and VTI [11.1 (8.2-13.4) cm] were significantly larger in successfully weaned group than the group who were not weaned [LVETc 144 (0-253) ms, p=0.004; VTI 5 (0-7.8) cm, p=0.002, Figure]. Univariate analysis revealed LVETc and VTI were significant predictors for successful weaning [LVETc, OR 1.02, 95%CI 1.01-1.04; VTI, OR 1.51, 95%CI 1.17-2.25, p<0.001, respectively]. Receiver operating curve analysis indicated that optimal LVETc and VTI points were 200 ms and 8.3 cm for predicting successful weaning (area under the curve 0.81 and 0.87, sensitivity 100 and 78% and specificity 58 and 90%).
Conclusion: These findings indicate that echocardiographic parameters of LVET and VTI seem to be potential predictors for successful weaning from ECMO.
Author Disclosures: K. Sawada: None. S. Kawakami: None. Y. Tahara: None. T. Nakashima: None. T. Nagai: None. T. Kanaya: None. Y. Kataoka: None. Y. Asaumi: None. T. Noguchi: None. S. Yasuda: None.
- © 2016 by American Heart Association, Inc.