Relationship between early onset ventricular fibrillation/ventricular tachycardia and prognosis in ECPR patients with ECMO support
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    Abstract:

    Objective:To retrospectively analyzethe incidence,risk factors,and prognosis of ventricular fibrillation/ventricular tachycardia(VF/VT)within 72 hours of extracorporeal cardiopulmonary resuscitation(ECPR)in patients supported by extracorporeal membrane oxygenation(ECMO). Methods:ECPR patients admitted to the Emergency Center of the First Affiliated Hospital of Nanjing Medical University from January 2017 to March 2023 were included. Patientswere divided into VF/VT group and nVF/VT group according to the occurrence of VF/VT within 72 hours of ECMO support. risk factors for VF/VT during ECMO support were analyzed through regression analysis,and the impact of VF/VT on clinical prognosis was explored. Results:A total of 95 patients with a mean age of(50.02±15.93)years were enrolled,with males accounting for 66.32%. The 28-day survival rate was 51.58%,and the incidence of VF/VT was 33.33%. Comparison among groups showed that the nVF/VT group had a higher rates of continuous renal replacement therapy,longer ECMO initiation time,and higher lactic acidlevels compared tothe VF/VT group.Troponin T(TnT)levels showed a trend of being higher in the VF/VT group,while the pH value was significantly lower in the VF/VT group compared to the nVF/VT group. Stepwise multivariable logistic regression analysis showed that the risk of maintaining high TNT levels significantly increased after VF/ VToccurrence,with an odds ratio(OR)of 18.156(95%CI:3.620-91.059). Prolonged ECMO initiation time(OR=1.118,95%CI:1.060- 1.180)and decreased pH value(OR=0.005,95%CI:0.000-0.953)were identified as independent risk factors for VF/VT occurrence. Conclusion:In patients with ECPR,the risk of VF/VT occurring within 72 hours of ECMO support issignificantly increased in patients with severe acidosis or prolonged ECMO initiation time. The onset of VF/VT does not affect the clinical prognosis but may exacerbate myocardial injury.

    Reference
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周浩,李伟,朱轶,张忠满,陈旭锋,吕金如. ECPR患者ECMO支持早期发作室颤/室速与预后关系[J].南京医科大学学报(自然科学版英文版),2023,(12):1656-1662.

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  • Received:August 19,2023
  • Online: December 12,2023
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