Diastolic BP in VA ECMO

Q: In predicting survival in patients who receive V-A ECMO, higher diastolic blood pressure is a? (select one)

A) protective factor

B) risk factor

Answer: A

A survival prediction model for those receiving V-A ECMO, derived from the Extracorporeal Life Support Organization (ELSO) Registry, called the SAVE (Survival After VA ECMO) score published in 2015. It identified risk and potential protective factors:

Risk factor: 

• Postcardiotomy cardiogenic shock
• Chronic renal failure
• Longer duration of ventilation prior to ECMO initiation
• Pre-ECMO organ failures
• Pre-ECMO cardiac arrest
• Congenital heart disease
• Lower pulse pressure
• Lower serum bicarbonate

Potentially protective factors: 

• Younger age
• Lower body weight
• Acute myocarditis
• Heart transplant
• Refractory ventricular tachycardia (VT) or fibrillation (VF)
• Higher diastolic blood pressure
• Lower peak inspiratory pressure

#hemodynamics

#procedures

#cardiology

Reference:

Schmidt M, Burrell A, Roberts L, et al. Predicting survival after ECMO for refractory cardiogenic shock: the survival after veno-arterial-ECMO (SAVE)-score. Eur Heart J 2015; 36:2246.