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: results of the PELS observational multicenter study
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| Název: | 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: results of the PELS observational multicenter study |
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| Autoři: | Chiarini, Giovanni, Mariani, Silvia, Schaefer, Anne-Kristin, van Bussel, Bas C. T., Di Mauro, Michele, Wiedemann, Dominik, Saeed, Diyar, Pozzi, Matteo, Botta, Luca, Boeken, Udo, Samalavicius, Robertas, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J. H., Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, Ramanathan, Kollengode, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P., Shekar, Kiran, Whitman, Glenn J. R., Lorusso, Roberto, on behalf of the PELS Investigators, Heuts, Samuel, Conci, Luca, Khalil, Jawad, Lehmann, Sven, Obadia, Jean-Francois, Loforte, Antonio, Pacini, Davide, Kalampokas, Nikolaos, Jankuviene, Agne, Flecher, Erwan, Dos Reis Miranda, Dinis, Sriranjan, Kogulan, Mazzeffi, Michael A., Di Eusanio, Marco, Vendramin, Igor, MacLaren, Graeme, Sorokin, Vitaly, Costetti, Alessandro, Schmid, Chistof, Castillo, Roberto, Grus, Tomas, Solinas, Marco |
| Přispěvatelé: | Chiarini, Giovanni, Mariani, Silvia, Schaefer, Anne-Kristin, van Bussel, Bas C T, Di Mauro, Michele, Wiedemann, Dominik, Saeed, Diyar, Pozzi, Matteo, Botta, Luca, Boeken, Udo, Samalavicius, Roberta, Bounader, Karl, Hou, Xiaotong, Bunge, Jeroen J H, Buscher, Hergen, Salazar, Leonardo, Meyns, Bart, Herr, Daniel, Matteucci, Sacha, Sponga, Sandro, Ramanathan, Kollengode, Russo, Claudio, Formica, Francesco, Sakiyalak, Pranya, Fiore, Antonio, Camboni, Daniele, Raffa, Giuseppe Maria, Diaz, Rodrigo, Wang, I-Wen, Jung, Jae-Seung, Belohlavek, Jan, Pellegrino, Vin, Bianchi, Giacomo, Pettinari, Matteo, Barbone, Alessandro, Garcia, José P, Shekar, Kiran, Whitman, Glenn J R, Lorusso, Roberto |
| Zdroj: | Crit Care |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2024. |
| Rok vydání: | 2024 |
| Témata: | Male, Adult, Subclavian Artery, Neurologic complications, GUIDELINES, Catheterization, Extracorporeal Membrane Oxygenation, Postoperative Complications, Critical Care Medicine, SDG 3 - Good Health and Well-being, General & Internal Medicine, Catheterization, Peripheral, INJURY, Humans, ADULT PATIENTS, Hospital Mortality, Cardiac Surgical Procedures, 11 Medical and Health Sciences, Aorta, Retrospective Studies, Aged, 2. Zero hunger, ICH, Science & Technology, 42 Health sciences, Extracorporeal membrane oxygenation, Research, Cardiac arrest, Cardiac surgery, Stroke, MEMBRANE-OXYGENATION, Cardiac Surgical Procedures/adverse effects [MeSH], Aged [MeSH], Hospital Mortality/trends [MeSH], Postoperative Complications/epidemiology [MeSH], Catheterization, Peripheral/adverse effects [MeSH], Nervous System Diseases/etiology [MeSH], Extracorporeal Membrane Oxygenation/statistics, Aorta [MeSH], Cardiac Surgical Procedures/methods [MeSH], Extracorporeal Membrane Oxygenation/methods [MeSH], Male [MeSH], Postoperative Complications/etiology [MeSH], Femoral Artery [MeSH], Catheterization/methods [MeSH], Female [MeSH], Catheterization/adverse effects [MeSH], Adult [MeSH], Humans [MeSH], Nervous System Diseases/epidemiology [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Catheterization, Peripheral/methods [MeSH], Extracorporeal Membrane Oxygenation/adverse effects [MeSH], Catheterization, Peripheral/statistics, Catheterization/statistics, Subclavian Artery [MeSH], 32 Biomedical and clinical sciences, Middle Aged, Emergency & Critical Care Medicine, 3. Good health, Neurologic complication, Settore MEDS-13/C - Chirurgia cardiaca, PELS Investigators, Femoral Artery, Female, Nervous System Diseases, Life Sciences & Biomedicine |
| Popis: | 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 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 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. Graphical abstract |
| Druh dokumentu: | Article Other literature type |
| Popis souboru: | application/pdf; application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Jazyk: | English |
| ISSN: | 1364-8535 |
| DOI: | 10.1186/s13054-024-05047-2 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/39113082 https://pure.eur.nl/en/publications/e7c48e94-6d21-4dba-ba65-02f8d474009b https://doi.org/10.1186/s13054-024-05047-2 https://cris.maastrichtuniversity.nl/en/publications/30a87182-3525-443d-b9ff-a8e5fcde4f4f https://doi.org/10.1186/s13054-024-05047-2 https://lirias.kuleuven.be/handle/20.500.12942/748981 https://doi.org/10.1186/s13054-024-05047-2 https://repository.publisso.de/resource/frl:6520041 https://hdl.handle.net/11585/1008091 https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-05047-2 https://doi.org/10.1186/s13054-024-05047-2 https://pubmed.ncbi.nlm.nih.gov/39113082/ https://doi.org/10.1186/s13054-024-05047-2 https://hdl.handle.net/2318/2005830 |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (http://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
| Přístupové číslo: | edsair.doi.dedup.....86a0e82243e34f96cf1af19d1655f4e4 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | 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 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 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. Graphical abstract |
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| ISSN: | 13648535 |
| DOI: | 10.1186/s13054-024-05047-2 |