Abstract:
PURPOSE:Information on predisposing risk factors influencing long-term survival after extracorporeal membrane oxygenation (ECMO) support remains scarce. In critically ill patients chronic obstructive pulmonary disease (COPD) is an independent risk factor for mortality and morbidity. We assessed the influence of COPD on cardiovascular and all-cause mortality in patients undergoing ECMO therapy. METHODS:We prospectively included 191 patients undergoing veno-arterial ECMO therapy following cardiovascular surgery at a university-affiliated tertiary care center into our registry. RESULTS:The median follow-up time was 51 months (IQR 34-71 months) corresponding to 4,197 overall months of follow-up. A total of 125 patients (65 %) died; 88 % of deaths were due to cardiovascular causes. Long-term survival was decreased in patients with COPD after 1 year (23 % vs. 44 %) and after 6 years (14 % vs. 35 %) compared to patients without COPD. COPD was independently associated with all-cause mortality with a hazard ratio of 4.22 (95 % CI 1.04-17.11, p = 0.04) and cardiovascular mortality with a hazard ratio of 5.87 (95 % CI 1.41-24.47, p = 0.02). CONCLUSIONS:We identified COPD as a strong and independent predictor of long-term all-cause mortality and cardiovascular mortality in patients undergoing ECMO therapy following cardiovascular surgery. The current study presents valuable information for a comprehensive decision-making process prior to ECMO implantation and helps to identify high-risk patients that may benefit from intensified treatment of co-morbidities and close check-ups after hospital discharge.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Distelmaier K,Niessner A,Haider D,Lang IM,Heinz G,Maurer G,Koinig H,Steinlechner B,Goliasch Gdoi
10.1007/s00134-013-2931-ysubject
Has Abstractpub_date
2013-08-01 00:00:00pages
1444-51issue
8eissn
0342-4642issn
1432-1238journal_volume
39pub_type
杂志文章abstract:OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-006-0265-8
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To study the influence of continuous administration of heparin on platelet function in intensive care patients. DESIGN:Prospective, serial investigation. SETTING:Clinical investigation on a surgical and neurosurgical intensive care unit in a university hospital. PATIENTS:The study included 45 patients: 15 ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050374
更新日期:1997-05-01 00:00:00
abstract::Arrhythmias are extremely common early after AMI. An arrhythmia is defined by exclusion, either because the sequence of myocardial depolarisation is other than normal or because certain arbitrary limits are exceeded. It follows that the term "arrhythmia" encompasses a complex heterogenous group. Although arrhythmias a...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01683131
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:We compared two imipenem regimens for prevention of septic complications in patients with severe acute necrotizing pancreatitis (ANP). DESIGN AND SETTING:Prospective, randomized open clinical trial involving intensive care units of 14 Spanish Hospitals. PARTICIPANTS:92 patients with ANP. INTERVENTIONS:Imip...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/s00134-003-1956-z
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To assess the effect of strict guidelines and a rigorous training program on variability in scoring the revised Acute Physiology and Chronic Health Evaluation (APACHE II). DESIGN AND SETTING:Prospective survey and intervention in the surgical ICU of a university teaching hospital. MEASUREMENTS:Seven experie...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s001340101012
更新日期:2001-08-01 00:00:00
abstract::We evaluated the effect of a cimetidine continuous infusion (2 g in 24 h) on the intragastric pH of 16 critically ill patients (11 men, 5 women, mean age 45 years). During the 24 h pre-trial period and the subsequent 24 h cimetidine infusion, an intragastric combined electrode was placed in the fundus and the pH recor...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00262892
更新日期:1988-01-01 00:00:00
abstract:PURPOSE:Little is known on the incidence of discomfort during the end-of-life of intensive care unit (ICU) patients and the impact of sedation on such discomfort. The aim of this study was to assess the incidence of discomfort events according to levels of sedation. METHODS:Post-hoc analysis of an observational prospe...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-020-05930-w
更新日期:2020-06-01 00:00:00
abstract::Two patients with chest injuries, flail chest and respiratory failure were mechanically ventilated by a system composed of 2 Bennett respirators and an independent source of gas. This system provides high-frequency positive pressure ventilation (HFPPV), low-frequency conventional mechanical ventilation (LFCMV) and hig...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00259437
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between the clinically evaluated depth of midazolam-induced sedation and the cardiac beat-to-beat variability (RR variability) in ICU patients in the intensive care unit (ICU). DESIGN:Prospective study. SETTING:ICU of a university hospital. PATIENTS:20 consecutive patients stu...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709555
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:Angiopoietin-2 (Ang-2) is a potent regulator of vascular permeability and inflammation in acute lung injury and acute respiratory distress syndrome (ARDS). Genetic variants in the Ang-2 gene may lead to altered activities of Ang-2 (or ANGPT2) gene. The aim of this study was to assess if genetic variants of An...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1413-8
更新日期:2009-06-01 00:00:00
abstract:PURPOSE:In critically ill pediatric patients, fluid overload (FO) >10% has been identified as a threshold for possible interventions, including initiation of continuous renal replacement therapy (CRRT). However, multiple definitions have been reported, and there remains no consensus method for FO calculation. The goal ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2503-6
更新日期:2012-04-01 00:00:00
abstract::As a result of the previous shortage of tools to assess objectively the overall physiological status of the respiratory system in infants and young children, it has been difficult to measure the degree of physiological disorder or the response to therapy in respiratory diseases such as BPD, the pediatric version of AR...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01704742
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To investigate ventilation-perfusion (VA/Q) relationships, during continuous axial rotation and in the supine position, in patients with acute lung injury (ALI) using the multiple inert gas elimination technique. DESIGN:Prospective investigation. SETTING:Eighteen-bed intensive care unit in a university hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050534
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To identify objective trends of the course of illness that might be used as benchmarks in the auditing of the organization/performance of Intensive Care Units (ICU). DESIGN:Retrospective analysis. PATIENTS AND SETTING:A group of 12,615 patients and 55,464 patient-days prospectively collected in 89 ICUs of 1...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1331-5
更新日期:2002-07-01 00:00:00
abstract::In hypoxia sensitive cells and tissues, the rates of glucose and O2 consumption are inversely related (Pasteur Effect). Under O2 limiting conditions the demands for glucose (glycogen) in such cells may drastically rise as a means for maintaining ATP turnover close to normoxic rates; nevertheless ion and electrical pot...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254926
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of antidotal therapy in patients with an elevated digitalis concentration following chronic or acute exposure. DESIGN AND SETTING:Retrospective review of patient records over 2 years in 20 city hospitals in France. PATIENTS:Overall 838 patients with an elevated serum digitalis concentrat...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1092-x
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To study plasma concentrations of interleukin 6 (IL-6) and interleukin 8 (IL-8) in patients with splanchnic hypoxia, as documented by gastric intramucosal measurements (pH-i), during major abdominal surgery and the relationship between IL-6 and IL-8 concentrations and postoperative complications as well as cl...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050575
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:To assess the reproducibility of respiratory dead space measurements in ventilated children. DESIGN:Prospective study. SETTING:University pediatric intensive care unit. PATIENTS:Thirty-two mechanically ventilated children (0.13-15.4 years) who were clinically stable. METHODS:The single-breath CO(2) test ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-004-2288-3
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To compare the total plasma cortisol values obtained from three widely used immunoassays and a high pressure liquid chromatography (HPLC) technique on samples obtained from patients with sepsis. DESIGN AND SETTING:Observational interventional in the general intensive care unit of a metropolitan hospital PAT...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0389-x
更新日期:2006-11-01 00:00:00
abstract::There has been little research on smoking cessation after critical illness. Smokers make up a high percentage of patients admitted to intensive care (ICU) and stopping smoking is one message that should be clearly given to recovering patients. The recovery period provides an important opportunity for patients to quit ...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s001340101051
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of nicotinamide (NIC), an inhibitor of poly(ADP-ribose) synthetase (PARS), on intestinal and liver perfusion, O2 kinetics, and energy metabolism over 24 h of hyperdynamic porcine endotoxemia. DESIGN:Prospective, randomized, controlled experimental study with repeated measures. SET...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000842
更新日期:2001-03-01 00:00:00
abstract:INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-010-1874-9
更新日期:2010-09-01 00:00:00
abstract:PURPOSE:Patients undergoing cardiac surgery often require transfusions of red blood cells, plasma and platelets. These components differ widely in both indications for use and composition. However, from a statistical point of view there is a significant colinearity between the components. This study explores the relati...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-012-2723-9
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:Common opioids for analgesia and sedation of mechanically ventilated infants may tend to accumulate and cause prolonged sedation with an unpredictable extubation time. Remifentanil is a promising option due to its unique pharmacokinetic properties, which seem to be valid in adults as well as in infants. METHOD...
journal_title:Intensive care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00134-012-2532-1
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of two different comorbidity measures on the 6-month mortality of severely ill cancer patients. DESIGN AND SETTING:Prospective cohort study in a ten-bed oncological medical-surgical intensive care unit (ICU). PATIENTS:A total of 772 consecutive patients were included over a 45-month p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2554-z
更新日期:2005-03-01 00:00:00
abstract::We have treated 30 patients with flail chest, with priority given to associated factors (pain, secretions retention, hemo-/pneumothorax and underlying pulmonary contusion). When this treatment was insufficient IMV + PEEP was instituted; in this group there was a 58.8% incidence of pneumonia, 47.5% of sepsis and 11.7 d...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01687161
更新日期:1980-08-01 00:00:00
abstract:OBJECTIVE:Inhalation of nitric oxide (NO) can improve oxygenation and decrease mean pulmonary artery pressure (MPAP) in patients with the acute respiratory distress syndrome (ARDS). It is not known whether inhaled NO exerts a similar effect in hypoxemic patients with chronic obstructive pulmonary disease (COPD). DESIG...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050290
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To describe the syndrome of rhabdomyolysis during bacterial sepsis with regard to incidence, blood bacteriology and complications and to examine the association between hyperosmolal state and rhabdomyolysis, evaluating the relationship between plasma osmolality (Posm) and serum creatine phosphokinase (CPK) le...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050882
更新日期:1999-05-01 00:00:00
abstract:PURPOSE:To describe the course of early organ dysfunction in a cohort of patients admitted in ICU suffering classic heatstroke. METHODS:Prospective observational single-centre cohort study with a 1-year follow-up. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:Clinical and biological data of 22 patients were anal...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1500-x
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). METHODS:Data of patients admitted ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-010-2043-x
更新日期:2011-02-01 00:00:00