October 26, 2017Circulation JournalOpen Access

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation　― Insights From the CHANGE PUMP Study ―

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Why the study?

Does a prediction model using 48-hour clinical data predict successful bridge to recovery in patients with fulminant myocarditis supported with percutaneous VA-ECMO?

Population

99 patients with fulminant myocarditis treated with percutaneous venoarterial extracorporeal membrane…

Design

Cohort

Follow-up

in-hospital

Authors

ASAkinori SawamuraIchinomiya Municipal City Hospital TOTakahiro OkumuraHeart Failure / Cardiomyopathy AHAkihiro HirakawaTokyo Medical and Dental University

Discussion

Member takes

Implication

May aid early risk stratification on VA-ECMO for fulminant myocarditis; leaves open external validation before clinical adoption.

Structured PICO

Does a prediction model using 48-hour clinical data predict successful bridge to recovery in patients with fulminant myocarditis supported with percutaneous VA-ECMO?

Population

99 patients with fulminant myocarditis (FM) treated with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO), mean age 52±16 years, 42% female, from 26 high-volume cardiovascular centers in Japan.

Intervention

Prediction model using clinical data at 48 hours after VA-ECMO initiation (LVEF, change in LVEF, and change in AST)

Outcome

Successful bridge to recovery (BTR), defined as VA-ECMO decannulation and subsequent survival to dischargehard clinical

Limitations

Retrospective design with missing values (selection bias)
Limited variables included (no aortic valve opening or right heart catheterization findings)
Some patients with ≤20% predicted probability still achieved successful BTR
LVEF measurement consistency not entirely robust due to visual bedside evaluation
No external validation

Cite This Study

Sawamura et al. (2017) studied this question.

synapsesocial.com/papers/6a7ee9190d396ca0cf0fbaa7 https://doi.org/10.1253/circj.cj-17-0549

Topics

Myocarditis

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Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation　― Insights From the CHANGE PUMP Study ―

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation　― Insights From the CHANGE PUMP Study ―

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation ― Insights From the CHANGE PUMP Study ―

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation ― Insights From the CHANGE PUMP Study ―

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation　― Insights From the CHANGE PUMP Study ―

Early Prediction Model for Successful Bridge to Recovery in Patients With Fulminant Myocarditis Supported With Percutaneous Venoarterial Extracorporeal Membrane Oxygenation　― Insights From the CHANGE PUMP Study ―