Key result
A lower 24-hour vasoactive-inotropic score was significantly associated with survival to decannulation in adult patients on VA-ECMO (OR 0.95; 95% CI 0.91-0.95; p<0.001).
Why the study?
The study evaluated whether the vasoactive-inotropic score could serve as an early prognostication tool for survival to decannulation in adult patients on VA-ECMO support.
Does the 24-hour vasoactive-inotropic score predict survival to decannulation in adult patients on VA-ECMO?
Cohort (n=265)
No
Does the 24-hour vasoactive-inotropic score predict survival to decannulation in adult patients on VA-ECMO?
Odds Ratio: 0.95 (95% CI 0.91–0.95)
Absolute Event Rate: 6.5% vs 12.3%
p-value: p=< 0.001
A lower vasoactive-inotropic score at 24 hours postcannulation is associated with higher odds of survival to decannulation in adult patients on VA-ECMO.
VIS may predict survival to decannulation in VA-ECMO; hypothesis-generating and requires prospective validation before clinical use.
Extracorporeal life support with venoarterial extracorporeal membrane oxygenation (VA-ECMO) is used to assist circulation in patients with severe cardiogenic shock or cardiac arrest. The vasoactive-inotropic score (VIS) is a standardized calculation of vasoactive medication support which uses coefficients for each medication that converts them to an equivalent value. The purpose of this study was to assess the VIS as an early prognostication tool for survival to decannulation patients on adult VA-ECMO support. This was a single-center, observational cohort study of adult patients who received VA-ECMO support compared based on their survival to decannulation. The primary endpoint was the VIS at hour 24 postcannulation. Among the 265 patients included in this study, 140 patients (52.8%) survived to decannulation of VA-ECMO. At 24 hours postcannulation, a lower VIS was observed in the group that survived decannulation (6.5 ± 7.5 vs. 12.3 ± 16.9; p < 0.001). Multivariate analysis performed also demonstrates an association between 24-hour VIS and survival to decannulation (odds ratio 0.95; 95% confidence interval, 0.91-0.95). This study suggests that the 24-hour VIS may be an early prognostic indicator in patients on VA-ECMO patients. http://links.lww.com/ASAIO/B39.
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Dunton et al. (2023) conducted a cohort in Severe cardiogenic shock or cardiac arrest requiring VA-ECMO (n=265). 24-hour vasoactive-inotropic score (VIS) was evaluated on VIS at hour 24 postcannulation (OR 0.95, 95% CI 0.91-0.95, p=< 0.001). A lower 24-hour vasoactive-inotropic score was significantly associated with survival to decannulation in adult patients on VA-ECMO (OR 0.95; 95% CI 0.91-0.95; p<0.001).
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