-
Je něco špatně v tomto záznamu ?
Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study
G. Chiarini, S. Mariani, AK. Schaefer, BCT. van Bussel, M. Di Mauro, D. Wiedemann, D. Saeed, M. Pozzi, L. Botta, U. Boeken, R. Samalavicius, K. Bounader, X. Hou, JJH. Bunge, H. Buscher, L. Salazar, B. Meyns, D. Herr, S. Matteucci, S. Sponga, K....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie
NLK
BioMedCentral
od 1997-04-01
BioMedCentral Open Access
od 1997
Directory of Open Access Journals
od 1998
Free Medical Journals
od 1997
PubMed Central
od 1997
Europe PubMed Central
od 1997
ProQuest Central
od 2015-01-01
Open Access Digital Library
od 1997-01-01
Open Access Digital Library
od 1997-08-01
Open Access Digital Library
od 1998-01-01
Medline Complete (EBSCOhost)
od 2011-02-01
Health & Medicine (ProQuest)
od 2015-01-01
ROAD: Directory of Open Access Scholarly Resources
od 1997
Springer Nature OA/Free Journals
od 1997-04-01
- MeSH
- aorta * MeSH
- arteria femoralis * MeSH
- arteria subclavia MeSH
- dospělí MeSH
- kardiochirurgické výkony škodlivé účinky metody MeSH
- katetrizace metody škodlivé účinky statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody škodlivé účinky statistika a číselné údaje MeSH
- mortalita v nemocnicích trendy MeSH
- nemoci nervového systému etiologie epidemiologie MeSH
- periferní katetrizace metody škodlivé účinky statistika a číselné údaje MeSH
- pooperační komplikace epidemiologie etiologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
BACKGROUND: Cerebral perfusion may change depending on arterial cannulation site and may affect the incidence of neurologic adverse events in post-cardiotomy extracorporeal life support (ECLS). The current study compares patients' neurologic outcomes with three commonly used arterial cannulation strategies (aortic vs. subclavian/axillary vs. femoral artery) to evaluate if each ECLS configuration is associated with different rates of neurologic complications. METHODS: This retrospective, multicenter (34 centers), observational study included adults requiring post-cardiotomy ECLS between January 2000 and December 2020 present in the Post-Cardiotomy Extracorporeal Life Support (PELS) Study database. Patients with Aortic, Subclavian/Axillary and Femoral cannulation were compared on the incidence of a composite neurological end-point (ischemic stroke, cerebral hemorrhage, brain edema). Secondary outcomes were overall in-hospital mortality, neurologic complications as cause of in-hospital death, and post-operative minor neurologic complications (seizures). Association between cannulation and neurological outcomes were investigated through linear mixed-effects models. RESULTS: This study included 1897 patients comprising 26.5% Aortic (n = 503), 20.9% Subclavian/Axillary (n = 397) and 52.6% Femoral (n = 997) cannulations. The Subclavian/Axillary group featured a more frequent history of hypertension, smoking, diabetes, previous myocardial infarction, dialysis, peripheral artery disease and previous stroke. Neuro-monitoring was used infrequently in all groups. Major neurologic complications were more frequent in Subclavian/Axillary (Aortic: n = 79, 15.8%; Subclavian/Axillary: n = 78, 19.6%; Femoral: n = 118, 11.9%; p < 0.001) also after mixed-effects model adjustment (OR 1.53 [95% CI 1.02-2.31], p = 0.041). Seizures were more common in Subclavian/Axillary (n = 13, 3.4%) than Aortic (n = 9, 1.8%) and Femoral cannulation (n = 12, 1.3%, p = 0.036). In-hospital mortality was higher after Aortic cannulation (Aortic: n = 344, 68.4%, Subclavian/Axillary: n = 223, 56.2%, Femoral: n = 587, 58.9%, p < 0.001), as shown by Kaplan-Meier curves. Anyhow, neurologic cause of death (Aortic: n = 12, 3.9%, Subclavian/Axillary: n = 14, 6.6%, Femoral: n = 28, 5.0%, p = 0.433) was similar. CONCLUSIONS: In this analysis of the PELS Study, Subclavian/Axillary cannulation was associated with higher rates of major neurologic complications and seizures. In-hospital mortality was higher after Aortic cannulation, despite no significant differences in incidence of neurological cause of death in these patients. These results encourage vigilance for neurologic complications and neuromonitoring use in patients on ECLS, especially with Subclavian/Axillary cannulation.
Adult Intensive Care Services The Prince Charles Hospital Brisbane Australia
Cardiac Intensive Care Unit Johns Hopkins Hospital Baltimore MD USA
Cardiac Surgery Unit Cardiac Thoracic and Vascular Department Niguarda Hospital Milan Italy
Cardiac Surgery Unit Fondazione IRCCS San Gerardo dei Tintori Monza Italy
Cardiac Surgery Unit IRCCS Humanitas Research Hospital Rozzano MI Italy
Departamento de Anestesia ECMO Unit Clínica Las Condes Las Condes Santiago Chile
Department of Cardiac Surgery Leipzig Heart Center Leipzig Germany
Department of Cardiac Surgery Louis Pradel Cardiologic Hospital Lyon France
Department of Cardiac Surgery Medical Faculty Heinrich Heine University Duesseldorf Germany
Department of Cardiac Surgery Medical University of Vienna Vienna Austria
Department of Cardiology Fundación Cardiovascular de Colombia Bucaramanga Colombia
Department of Cardiothoracic Surgery University Medical Center Regensburg Regensburg Germany
Department of Cardiovascular Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Intensive Care Adults and Cardiology Erasmus MC Rotterdam The Netherlands
Department of Thoracic and Cardiovascular Surgery Korea University Anam Hospital Seoul South Korea
Departments of Medicine and Surgery University of Maryland Baltimore USA
Division of Cardiac Surgery Cardiothoracic Department University Hospital of Udine Udine Italy
Division of Cardiac Surgery IRCCS Azienda Ospedaliero Universitaria Di Bologna Bologna Italy
Division of Cardiac Surgery Memorial Healthcare System Hollywood FL 33021 USA
Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital Rennes France
Intensive Care Unit Spedali Civili University Hospital Brescia Italy
Intensive Care Unit The Alfred Hospital Melbourne VIC Australia
IU Health Advanced Heart and Lung Care Indiana University Methodist Hospital Indianapolis IN USA
Ospedale del Cuore Fondazione Toscana G Monasterio Massa Italy
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc24019379
- 003
- CZ-PrNML
- 005
- 20241024110824.0
- 007
- ta
- 008
- 241015s2024 enk f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1186/s13054-024-05047-2 $2 doi
- 035 __
- $a (PubMed)39113082
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a enk
- 100 1_
- $a Chiarini, Giovanni $u Cardio-Thoracic Surgery Department, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan, 25-6202AZ, Maastricht, The Netherlands. giovanni.chiarini88@gmail.com $u Intensive Care Unit, Spedali Civili University Hospital, Brescia, Italy. giovanni.chiarini88@gmail.com
- 245 10
- $a Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study / $c G. Chiarini, S. Mariani, AK. Schaefer, BCT. van Bussel, M. Di Mauro, D. Wiedemann, D. Saeed, M. Pozzi, L. Botta, U. Boeken, R. Samalavicius, K. Bounader, X. Hou, JJH. Bunge, H. Buscher, L. Salazar, B. Meyns, D. Herr, S. Matteucci, S. Sponga, K. Ramanathan, C. Russo, F. Formica, P. Sakiyalak, A. Fiore, D. Camboni, GM. Raffa, R. Diaz, IW. Wang, JS. Jung, J. Belohlavek, V. Pellegrino, G. Bianchi, M. Pettinari, A. Barbone, JP. Garcia, K. Shekar, GJR. Whitman, R. Lorusso, PELS Investigators
- 520 9_
- $a BACKGROUND: Cerebral perfusion may change depending on arterial cannulation site and may affect the incidence of neurologic adverse events in post-cardiotomy extracorporeal life support (ECLS). The current study compares patients' neurologic outcomes with three commonly used arterial cannulation strategies (aortic vs. subclavian/axillary vs. femoral artery) to evaluate if each ECLS configuration is associated with different rates of neurologic complications. METHODS: This retrospective, multicenter (34 centers), observational study included adults requiring post-cardiotomy ECLS between January 2000 and December 2020 present in the Post-Cardiotomy Extracorporeal Life Support (PELS) Study database. Patients with Aortic, Subclavian/Axillary and Femoral cannulation were compared on the incidence of a composite neurological end-point (ischemic stroke, cerebral hemorrhage, brain edema). Secondary outcomes were overall in-hospital mortality, neurologic complications as cause of in-hospital death, and post-operative minor neurologic complications (seizures). Association between cannulation and neurological outcomes were investigated through linear mixed-effects models. RESULTS: This study included 1897 patients comprising 26.5% Aortic (n = 503), 20.9% Subclavian/Axillary (n = 397) and 52.6% Femoral (n = 997) cannulations. The Subclavian/Axillary group featured a more frequent history of hypertension, smoking, diabetes, previous myocardial infarction, dialysis, peripheral artery disease and previous stroke. Neuro-monitoring was used infrequently in all groups. Major neurologic complications were more frequent in Subclavian/Axillary (Aortic: n = 79, 15.8%; Subclavian/Axillary: n = 78, 19.6%; Femoral: n = 118, 11.9%; p < 0.001) also after mixed-effects model adjustment (OR 1.53 [95% CI 1.02-2.31], p = 0.041). Seizures were more common in Subclavian/Axillary (n = 13, 3.4%) than Aortic (n = 9, 1.8%) and Femoral cannulation (n = 12, 1.3%, p = 0.036). In-hospital mortality was higher after Aortic cannulation (Aortic: n = 344, 68.4%, Subclavian/Axillary: n = 223, 56.2%, Femoral: n = 587, 58.9%, p < 0.001), as shown by Kaplan-Meier curves. Anyhow, neurologic cause of death (Aortic: n = 12, 3.9%, Subclavian/Axillary: n = 14, 6.6%, Femoral: n = 28, 5.0%, p = 0.433) was similar. CONCLUSIONS: In this analysis of the PELS Study, Subclavian/Axillary cannulation was associated with higher rates of major neurologic complications and seizures. In-hospital mortality was higher after Aortic cannulation, despite no significant differences in incidence of neurological cause of death in these patients. These results encourage vigilance for neurologic complications and neuromonitoring use in patients on ECLS, especially with Subclavian/Axillary cannulation.
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a retrospektivní studie $7 D012189
- 650 _2
- $a lidé středního věku $7 D008875
- 650 12
- $a arteria femoralis $7 D005263
- 650 12
- $a mimotělní membránová oxygenace $x metody $x škodlivé účinky $x statistika a číselné údaje $7 D015199
- 650 _2
- $a senioři $7 D000368
- 650 12
- $a aorta $7 D001011
- 650 _2
- $a nemoci nervového systému $x etiologie $x epidemiologie $7 D009422
- 650 _2
- $a dospělí $7 D000328
- 650 _2
- $a arteria subclavia $7 D013348
- 650 _2
- $a katetrizace $x metody $x škodlivé účinky $x statistika a číselné údaje $7 D002404
- 650 _2
- $a periferní katetrizace $x metody $x škodlivé účinky $x statistika a číselné údaje $7 D002406
- 650 _2
- $a kardiochirurgické výkony $x škodlivé účinky $x metody $7 D006348
- 650 _2
- $a pooperační komplikace $x epidemiologie $x etiologie $7 D011183
- 650 _2
- $a mortalita v nemocnicích $x trendy $7 D017052
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a multicentrická studie $7 D016448
- 655 _2
- $a pozorovací studie $7 D064888
- 700 1_
- $a Mariani, Silvia $u Cardio-Thoracic Surgery Department, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan, 25-6202AZ, Maastricht, The Netherlands $u Cardiac Surgery Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- 700 1_
- $a Schaefer, Anne-Kristin $u Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
- 700 1_
- $a van Bussel, Bas C T $u Department of Intensive Care Medicine, and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- 700 1_
- $a Di Mauro, Michele $u Cardio-Thoracic Surgery Department, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan, 25-6202AZ, Maastricht, The Netherlands
- 700 1_
- $a Wiedemann, Dominik $u Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria $u Department of Cardiac Surgery, Karl Landsteiner University, University Clinic St, Pölten, St. Pölten, Austria
- 700 1_
- $a Saeed, Diyar $u Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
- 700 1_
- $a Pozzi, Matteo $u Department of Cardiac Surgery, Louis Pradel Cardiologic Hospital, Lyon, France
- 700 1_
- $a Botta, Luca $u Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- 700 1_
- $a Boeken, Udo $u Department of Cardiac Surgery, Medical Faculty, Heinrich Heine University, Duesseldorf, Germany
- 700 1_
- $a Samalavicius, Robertas $u II Department of Anesthesiology, Centre of Anesthesia, Intensive Care and Pain Management, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
- 700 1_
- $a Bounader, Karl $u Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France
- 700 1_
- $a Hou, Xiaotong $u Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- 700 1_
- $a Bunge, Jeroen J H $u Department of Intensive Care Adults and Cardiology, Erasmus MC, Rotterdam, The Netherlands
- 700 1_
- $a Buscher, Hergen $u Department of Intensive Care Medicine, Center of Applied Medical Research, St Vincent's Hospital, Darlinghurs, NSW, Australia $u University of New South Wales, Sydney, Australia
- 700 1_
- $a Salazar, Leonardo $u Department of Cardiology, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia
- 700 1_
- $a Meyns, Bart $u Department of Cardiac Surgery, Department of Cardiovascular Sciences, University of Leuven, Louvain, Belgium
- 700 1_
- $a Herr, Daniel $u Departments of Medicine and Surgery, University of Maryland, Baltimore, USA
- 700 1_
- $a Matteucci, Sacha $u SOD Cardiochirurgia Ospedali Riuniti 'Umberto I - Lancisi - Salesi' Università Politecnica delle Marche, Ancona, Italy
- 700 1_
- $a Sponga, Sandro $u Division of Cardiac Surgery, Cardiothoracic Department, University Hospital of Udine, Udine, Italy
- 700 1_
- $a Ramanathan, Kollengode $u Cardiothoracic Intensive Care Unit, National University Heart Centre, National University Hospital, Singapore, Singapore
- 700 1_
- $a Russo, Claudio $u Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy
- 700 1_
- $a Formica, Francesco $u Cardiac Surgery Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy $u Department of Medicine and Surgery, Cardiac Surgery Unit, University of Parma, University Hospital of Parma, Parma, Italy
- 700 1_
- $a Sakiyalak, Pranya $u Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- 700 1_
- $a Fiore, Antonio $u Department of Cardiac Surgery, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Creteil, France
- 700 1_
- $a Camboni, Daniele $u Department of Cardiothoracic Surgery, University Medical Center Regensburg, Regensburg, Germany
- 700 1_
- $a Raffa, Giuseppe Maria $u Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo Per I Trapianti e Terapie Ad Alta Specializzazione), Palermo, Italy
- 700 1_
- $a Diaz, Rodrigo $u Departamento de Anestesia, ECMO Unit, Clínica Las Condes, Las Condes, Santiago, Chile
- 700 1_
- $a Wang, I-Wen $u Division of Cardiac Surgery, Memorial Healthcare System, Hollywood, FL, 33021, USA
- 700 1_
- $a Jung, Jae-Seung $u Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Seoul, South Korea
- 700 1_
- $a Belohlavek, Jan $u 2nd Department of Internal Medicine, Cardiovascular Medicine General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
- 700 1_
- $a Pellegrino, Vin $u Intensive Care Unit, The Alfred Hospital, Melbourne, VIC, Australia
- 700 1_
- $a Bianchi, Giacomo $u Ospedale del Cuore Fondazione Toscana "G. Monasterio", Massa, Italy
- 700 1_
- $a Pettinari, Matteo $u Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
- 700 1_
- $a Barbone, Alessandro $u Cardiac Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy
- 700 1_
- $a Garcia, José P $u IU Health Advanced Heart and Lung Care, Indiana University Methodist Hospital, Indianapolis, IN, USA
- 700 1_
- $a Shekar, Kiran $u Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Australia
- 700 1_
- $a Whitman, Glenn J R $u Cardiac Intensive Care Unit, Johns Hopkins Hospital, Baltimore, MD, USA
- 700 1_
- $a Lorusso, Roberto $u Cardio-Thoracic Surgery Department, Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, P. Debyelaan, 25-6202AZ, Maastricht, The Netherlands
- 710 2_
- $a PELS Investigators
- 773 0_
- $w MED00006603 $t Critical care (London, England) $x 1466-609X $g Roč. 28, č. 1 (2024), s. 265
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/39113082 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y - $z 0
- 990 __
- $a 20241015 $b ABA008
- 991 __
- $a 20241024110818 $b ABA008
- 999 __
- $a ok $b bmc $g 2201924 $s 1231352
- BAS __
- $a 3
- BAS __
- $a PreBMC-MEDLINE
- BMC __
- $a 2024 $b 28 $c 1 $d 265 $e 20240807 $i 1466-609X $m Critical care (London, England) $n Crit Care $x MED00006603
- LZP __
- $a Pubmed-20241015
