ORIGINAL ARTICLE
Procalcitonin dynamics, lactates, and haemoglobin serum levels might be a useful predictive tool of mortality in patients undergoing veno-venous extracorporeal oxygenation membrane support. Single centre experience
 
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1
Student’s Scientific Association, II Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland
 
2
II Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland
 
 
Submission date: 2019-08-22
 
 
Final revision date: 2019-09-13
 
 
Acceptance date: 2019-09-13
 
 
Publication date: 2019-12-04
 
 
Anaesthesiol Intensive Ther 2019;51(5):343-347
 
KEYWORDS
TOPICS
ABSTRACT
Background:
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a well-established therapeutic option in respiratory failure refractory to mechanical ventilation. Due to the growing popularity of VV-ECMO, new methods to improve patient outcome are desired. This study aimed to evaluate the impact of patient age, sequential organ failure assessment score, respiratory ECMO survival prediction score, and early laboratory results on mortality of patients undergoing VV-ECMO.

Methods:
The study population included 39 patients who underwent VV-ECMO between 2016 and 2019. The study compared the laboratory results during the first three days of therapy. The parameters included procalcitonin, C-reactive protein, haemoglobin, lactates, arterial blood partial pressure of carbon dioxide and oxygen.

Results:
The decrease of procalcitonin by 10% between the 1st and the 3rd day was more often observed in the positive outcome group (71.4% vs. 38.9%, P = 0.041). Serum lactate concentrations at the 1st day corresponded with the negative outcome (AUC = 0.70, P = 0.026). The negative outcome group had a higher occurrence of serum lactates of 2 mmol L-1 at the 1st day (P = 0.039). The haemoglobin levels at the 1st and 3rd day corresponded with patients’ outcome (AUC = 0.69, P = 0.023 and AUC = 0.074, P = 0.006, respectively).

Conclusions:
The study showed significant differences in early laboratory results between patients with a positive and negative outcome. In our opinion, serum lactate, haemoglobin and procalcitonin concentrations should be monitored daily to ensure an optimal therapeutic strategy and improve patient outcome. Our study provides valuable observations on predictive tools in VV-ECMO and possible directions for future research.
REFERENCES (13)
1.
Schmidt M, Hodgson C, Combes A. Extracorporeal gas exchange for acute respiratory failure in adult patients: a systemic review. Crit Care 2015; 19: 99-113. doi: https://doi.org/10.1186/s13054....
 
2.
International Registry of Extracorporeal Life Support Organization. Available at: https://www.elso.org/ Registry/Statistics.aspx.
 
3.
Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 1988; 4: 720-723. doi: https://doi.org/10.1164/ajrccm....
 
4.
Huesch M, Brehm C. The challanges in predicting ECMO survival, and a path forward. ASAIO J 2017; 63: 847-848. doi: https://doi.org/10.1097/MAT.00....
 
5.
Rozencwajg S, Pilcher D, Combes A, Shmidt M. Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenation. Crit Care 2016; 20: 392-402. doi: https://dx.doi.org/10.1186%2Fs....
 
6.
Nargis W, Ibrahim M, Ahamed BU. Procalcitonin versus C-reactive protein: Usefulness as biomarker of sepsis in ICU patient. Int J Crit Illn Inj Sci 2014; 4: 195-199. doi: https://doi.org/10.4103/2229-5....
 
7.
Nin N, Muriel A, Peńuelas O, et al. Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome. Intensive Care Med 2017; 43: 200-208. doi: https://doi.org/10.1007/s00134....
 
8.
Lango R, Szkulmowski Z, Maciejewski D, Sosnowski A, Kusza K. Revised protocol of extracorporeal membrane oxygenation (ECMO) therapy in severe ARDS. Recommendations of the veno-venous ECMO Expert Panel appointed in February 2016 by the national consultant on anesthesiology and intensive care. Anaesthesiol Intensive Ther 2017; 49: 88-99. doi: https://doi.org/10.5603/AIT.a2....
 
9.
Voelker MT, Busch T, Bercker S, Fichtner F, Kaisers UX, Laudi S. Restrictive transfusion practice during extracorporeal membrane oxy­genation therapy for severe acute respiratory distress syndrome. Artif Organs 2015; 39: 374-378. doi: https://doi.org/10.1111/aor.12....
 
10.
Agrastrand CL, Burkart KM, Abrams DC, Bacchetta MD, Brodie D. Blood conservation in extracorporeal membrane oxygenation for acute respiratory distress syndrome. Ann Thorac Surg 2015; 99: 590-595. doi: https://doi.org/10.1016/j.atho....
 
11.
Hyoung SK, Sunghoon P. Blood Transfusion Strategies in Patients Undergoing Extracorporeal Membrane Oxygenation. Korean J Crit Care Med 2017; 32: 22-28. doi: https://doi.org/10.4266/kjccm.....
 
12.
Slottosch I, Liakopoulos O, Kuhn E, et al. Lactate and lactate clearance as valuable tool to evaluate ECMO theraphy in cardiogenic shock. J Crit Care 2017; 42: 35-41. doi: https://doi.org/10.1016/j.jcrc. 2017.06.022.
 
13.
Gao N, Yan C, Zhang G. Changes of serum procalcitonin (PCT), C-reactive protein (CRP), interleukin-17 (IL-17), interleukin-6 (IL-6), high mobility group protein-B1 (HMGB1) and D-dimer in patients with severe acute pancreatitis treated with continuous renal replacement therapy (CRRT) and its clinical significance. Med Sci Monit 2018; 24: 5881-5886. doi: https://doi.org/10.12659/MSM.9....
 
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