Prognostic Factors Of Patients With Cardiogenic Shock Treated With VA-ECMO

Objective: At present,the number of patients with ECMO in the treatment of cardiogenic shock is increasing gradually,but there is still a controversy about the related factors of prognosis.This paper mainly evaluates whether the patients have influence on the prognosis through the blood test index,general situation,related complications and treatment measures during ECMO assisted treatment.Meanwhile,safe score was used to evaluate the capacity state of ECMO during the operation period,and the relationship between liquid management and mortality was studied.Methods: 38 patients with cardiogenic shock received VA ECMO treatment were studied retrospectively in the ICU from August 2018 to November 2020,affiliated to Anhui Provincial Hospital Affiliated to Anhui Medical University.Collect general data of patients,such as gender and age of patients.The clinical data collection mainly includes the levels of troponin and BNP three days before the treatment,the positive and negative balance of liquid and safe score three days before admission,whether the patients were given CRRT or IABP treatment,and whether there were complications such as thrombosis and bleeding.The patients were divided into two groups: death group and survival group,and statistical analysis was conducted.Results:There were 16 male patients(42.10%),22 female patients(57.90%),and 22 patients died within 28 days(57.90%).Although there was no significant difference in age,gender,BNP level after admission,whether cardiopulmonary resuscitation,malignant arrhythmia,whether combined with CRRT,IABP or PCI,the APACHE II score of the two groups was p < 0.05.Although there was no difference in troponin level between the two days before operation,the value of troponin on the third day was p < 0.05,and the value of safe score on the third day was p < 0.01.APACHE II score,troponin level on the third day and safe score on the third day were included in the multivariate logistic regression analysis.Results the statistical results of troponin on the third day were p < 0.05,or = 1.04,The 95% confidence interval was 1.00-1.08,the statistical results of safe score on the third day: P < 0.05,or = 2.07,95% confidence interval was 1.13-3.78,and the KM curve was drawn with time as the horizontal axis and survival rate as the vertical axis.The mortality rate of patients in high blood volume group was significantly higher than that of patients in isovolumic group.Cox regression equation analysis showed that the safe score on the third day was p < 0.05,HR = 2.86,The 95% confidence interval was 1.13-7.24.Conclusion:In the patients with cardiogenic shock treated with VA-ECMO,the patients with significant decrease of cardiac troponin indicated that the cardiac function was improved and the survival rate was significantly increased.Safe score is also suitable for ECMO patients,and patients with high blood volume have higher mortality.Cardiac troponin on the third day and safe score on the third day affect the prognosis of patients with cardiogenic shock.The high blood volume of safe score on the third day is the promoting factor leading to death...