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Quantitative evaluation of hemodynamic parameters by echocardiography in patients with postcardiotomy cardiac shock supported by extracorporeal membrane oxygenation
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  • Fu-Yong Ye,
  • Yuwen Yang,
  • Xiaofang Li,
  • Fei Lin,
  • Yin-Ting Liang,
  • Jianhua Liu
Fu-Yong Ye
The First Affiliated Hospital of Jinan University
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Yuwen Yang
The First Affiliated Hospital of Jinan University
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Xiaofang Li
Gaozhou People’s Hospital
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Fei Lin
Gaozhou People’s Hospital
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Yin-Ting Liang
Gaozhou People’s Hospital
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Jianhua Liu
The First Affiliated Hospital of Jinan University
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Abstract

Objective: To investigate the value of echocardiography in monitoring hemodynamics of postcardiotomy cardiac shock (PCS) patients before, during, and after weaning from extracorporeal membrane oxygenation (ECMO). Methods: Fifty-two patients were divided into a successful weaning group (Group A, n=23) and non-successful group (Group B, n=29). Hemodynamic parameters measured by echocardiography were collected before, during, and after ECMO. The intra-group changes and inter-group differences were analyzed. Results: In group A, the central venous pressure (CVP), proximal right ventricular outflow tract (RVOT), tricuspid annular plane systolic excursion (TAPSE), velocity of tricuspid valve (TVDV), and systolic velocity of tricuspid annulus (s‘TV) during EMCO were significantly lower than before ECMO. After ECMO, left ventricular ejection fraction (LVEF), systolic velocity of mitral annulus (s‘MV), and velocity-time integral of LV outflow tract (LVOT-VTI) were higher than pre-ECMO, and CVP, LVEF, s‘MV, LVOT-VTI, RVOT, TAPSE, TVDV and s‘TV were higher than during ECMO (all p<0.05). In group B, compared to pre-ECMO, subjects exhibited decreased CVP, RVOT, TAPSE, TVDV and s‘TV during ECMO. TAPSE, TVDV, and s‘TV were continuously lower after ECMO, while CVP and RVOT became higher after ECMO (all p<0.05). After ECMO, LVEF, s‘MV, LVOT-VTI, TAPSE, TVDV and s‘TV in group A were higher than those in group B (all p<0.05). Multiple logistic regression analysis showed that LVEF (OR=1.387, 95%CI: 1.072-1.793, p=0.013) and Tei index (OR=-0.005, 95% CI: 0.000-0.939, p=0.047) were independent factors related to the successfulness of ECMO weaning. Conclusions: Quantitative assessment of both LV and RV by echocardiography is important for ECMO weaning.

Peer review status:UNDER REVIEW

05 May 2021Submitted to Echocardiography
06 May 2021Assigned to Editor
06 May 2021Submission Checks Completed
06 May 2021Reviewer(s) Assigned