Kozakov, Kostiantyn and Philipp, Alois and Lunz, Dirk and Lubnow, Matthias and Provaznik, Zdenek and Keyser, Andreas and Rupprecht, Leopold and Schmid, Christof and Schopka, Simon (2022) Multi-organ dysfunction syndrome in patients undergoing extracorporeal life support. ARTIFICIAL ORGANS, 46 (9). pp. 1912-1922. ISSN 0160-564X, 1525-1594
Full text not available from this repository. (Request a copy)Abstract
Background Multiple organ failure is a common complication in patients undergoing ECLS significantly affecting patient outcomes. Gaining knowledge about the mechanisms of onset, clinical course, risk factors, and potential therapeutic targets is highly desirable. Methods Data of 354 patients undergoing ECLS with one-, two, three-, and four organ failures were retrospectively analyzed. Incidence of multiple organ dysfunction (MODS), its impact on survival, risk factors for its occurrence, and the impact of proinflammatory mediators on the occurrence of MODS in patients undergoing ECLS were investigated. Results The median follow-up was 66 (IQR 6; 820) days. 245 (69.2%) patients could be weaned from ECLS, 30-day survival and 1-year survival were 194 (54.1%) and 157 (44.4%), respectively. The duration of mechanical support was 4 (IQR 2; 7) days in the median. Increasing severity of MODS resulted in significant prolongation of mechanical circulatory support and worsening of the outcome. Liver dysfunction had the strongest impact on patient mortality (OR = 2.5) and survival time (19 vs 367 days). The serum concentration of analyzed interleukins rose significantly with each, additional organ affected by dysfunction (p < 0.001). All analyzed proinflammatory cytokines showed significant predictivity relative to the occurrence of MODS with interleukin 8 serum level prior to ECLS showing the strongest predictive potential for the occurrence of MODS (AUC 0.78). Conclusion MODS represents a frequent complication in patients undergoing ECLS with a significant impact on survival. Proinflammatory cytokines show prognostic capacity regarding the occurrence and severity of multi-organ dysfunction.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MEMBRANE-OXYGENATION; CARDIOGENIC-SHOCK; ORGAN DYSFUNCTION; PLASMA-EXCHANGE; COMPLICATIONS; METAANALYSIS; SURVIVAL; FAILURE; SEPSIS; cardiac failure; extracorporeal life support; extracorporeal membrane oxygenation; interleukins; mortality; multi-organ failure; risk factors |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Nov 2023 13:23 |
| Last Modified: | 14 Nov 2023 13:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/56737 |
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