Modifiable Mechanical Ventilation Targets Are Associated With Improved Survival in Ventilated VA-ECLS Patients.
Publication/Presentation Date
8-1-2023
Abstract
BACKGROUND: In acute respiratory distress syndrome (ARDS), lung protective ventilation (LPV) improves patient outcomes by minimizing ventilator-induced lung injury. The value of LPV in ventilated patients with cardiogenic shock (CS) requiring venoarterial extracorporeal life support (VA-ECLS) is not known, but the extracorporeal circuit provides a unique opportunity to modify ventilatory parameters to improve outcomes.
OBJECTIVES: The authors hypothesized that CS patients on VA-ECLS who require mechanical ventilation (MV) may benefit from low intrapulmonary pressure ventilation (LPPV), which has the same end goals as LPV.
METHODS: The authors queried the ELSO (Extracorporeal Life Support Organization) registry for hospital admissions between 2009 and 2019 for CS patients on VA-ECLS and MV. They defined LPPV as peak inspiratory pressure at 24 hours on ECLS ofH
RESULTS: A total of 2,226 CS patients on VA-ECLS were included: 1,904 received LPPV. The primary outcome was higher in the LPPV group vs the no-LPPV group (47.4% vs 32.6%; P < 0.001). Median peak inspiratory pressure (22 vs 24 cm H
CONCLUSIONS: LPPV is associated with improved outcomes in CS patients on VA-ECLS requiring MV.
Volume
11
Issue
8 Pt 1
First Page
961
Last Page
968
ISSN
2213-1787
Published In/Presented At
Rali, A. S., Tran, L. E., Auvil, B., Xu, M., Huang, S., Labrada, L., Schlendorf, K. H., Bacchetta, M. D., Shah, A. S., Hernandez, A., & Lindenfeld, J. (2023). Modifiable Mechanical Ventilation Targets Are Associated With Improved Survival in Ventilated VA-ECLS Patients. JACC. Heart failure, 11(8 Pt 1), 961–968. https://doi.org/10.1016/j.jchf.2023.03.023
Disciplines
Medicine and Health Sciences
PubMedID
37178085
Department(s)
Department of Medicine
Document Type
Article
