The Impact of Hypoxic Hepatitis on Clinical Outcomes after Extracorporeal Cardiopulmonary Resuscitation
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Data Collection, Definitions, and Outcomes
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Hepatic Dysfunction and Mortality
3.3. Clinical Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
Abbreviations
AST | aspartate aminotransferase; |
ALT | alanine aminotransferase; |
CPR | cardiopulmonary resuscitation; |
CRRT | continuous renal replacement therapy; |
ECMO | extracorporeal membrane oxygenation; |
ECPR | extracorporeal cardiopulmonary resuscitation; |
HH | hypoxic hepatitis; |
INR | international normalized ratio. |
References
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HH (n = 90) | Non-HH (n = 275) | p Value | |
---|---|---|---|
Patient demographics | |||
Age (year) | 59.5 (47–71) | 62 (52–72) | 0.203 |
Gender, male | 67 (74.4%) | 185 (67.3%) | 0.201 |
Weight (kg) | 66 (57.2–75.8) | 65 (57.3–72.2) | 0.360 |
Smoking | 31 (34.8%) | 95 (34.8%) | 0.995 |
Comorbidities | |||
Diabetes mellitus | 28 (31.1%) | 94 (34.2%) | 0.592 |
Hypertension | 36 (40.0%) | 141 (51.3%) | 0.063 |
Malignancy | 18 (20.0%) | 40 (14.5%) | 0.219 |
Dyslipidemia | 11 (12.2%) | 35 (12.7%) | 0.900 |
Chronic kidney disease a | 6 (6.7%) | 41 (14.9%) | 0.043 |
Chronic liver disease | 6 (6.7%) | 20 (7.3%) | 0.846 |
Previous coronary artery disease | 16 (17.8%) | 51 (18.5%) | 0.870 |
Arrest due to ischemic heart disease | 38 (42.2%) | 142 (51.6%) | 0.121 |
Initial shockable rhythm | 22 (24.4%) | 95 (34.5%) | 0.075 |
Out-of-hospital cardiac arrest | 6 (6.7%) | 42 (15.3%) | 0.036 |
ECPR details | |||
CPR to ECMO pump-on time (min) | 35 (20–53) | 30 (20–47) | 0.373 |
ECMO duration (day) | 3 (1–6) | 1 (0–3) | <0.001 |
In-hospital management | |||
Mechanical ventilator | 82 (91.1%) | 232 (84.4%) | 0.109 |
CRRT | 54 (60.0%) | 83 (30.2%) | <0.001 |
Vasopressor | 88 (97.8%) | 255 (92.7%) | 0.081 |
* Adjusted OR (95% CI) | p Value | |
---|---|---|
Age (year) | 0.983 (0.966–0.999) | 0.046 |
Gender, male | 1.503 (0.839–2.691) | 0.171 |
Chronic liver disease | 0.868 (0.310–2.429) | 0.788 |
Arrest due to ischemic heart disease | 0.955 (0.544–1.675) | 0.873 |
Initial shockable rhythm | 0.605 (0.333–1.098) | 0.098 |
Out-of-hospital cardiac arrest | 2.449 (0.950–6.313) | 0.064 |
CPR to ECMO pump-on time ≥ 30 min | 1.608 (0.944–2.736) | 0.080 |
CRRT | 3.518 (2.103–5.885) | <0.001 |
* Adjusted OR (95% CI) | p Value | |
---|---|---|
Age (year) | 1.033 (1.015–1.051) | <0.001 |
Arrest due to ischemic heart disease | 0.517 (0.301–0.889) | 0.017 |
Initial shockable rhythm | 0.452 (0.261–0.782) | 0.005 |
Out-of-hospital cardiac arrest | 3.114 (1.401–6.923) | 0.005 |
CPR to ECMO pump-on time (min) | 1.036 (1.023–1.050) | <0.001 |
CRRT | 1.880 (1.073–3.293) | 0.027 |
HH | 1.955 (1.048–3.647) | 0.035 |
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Lee, Y.I.; Kang, M.G.; Ko, R.-E.; Park, T.K.; Chung, C.R.; Cho, Y.H.; Jeon, K.; Suh, G.Y.; Yang, J.H. The Impact of Hypoxic Hepatitis on Clinical Outcomes after Extracorporeal Cardiopulmonary Resuscitation. J. Clin. Med. 2020, 9, 2994. https://doi.org/10.3390/jcm9092994
Lee YI, Kang MG, Ko R-E, Park TK, Chung CR, Cho YH, Jeon K, Suh GY, Yang JH. The Impact of Hypoxic Hepatitis on Clinical Outcomes after Extracorporeal Cardiopulmonary Resuscitation. Journal of Clinical Medicine. 2020; 9(9):2994. https://doi.org/10.3390/jcm9092994
Chicago/Turabian StyleLee, Yun Im, Min Goo Kang, Ryoung-Eun Ko, Taek Kyu Park, Chi Ryang Chung, Yang Hyun Cho, Kyeongman Jeon, Gee Young Suh, and Jeong Hoon Yang. 2020. "The Impact of Hypoxic Hepatitis on Clinical Outcomes after Extracorporeal Cardiopulmonary Resuscitation" Journal of Clinical Medicine 9, no. 9: 2994. https://doi.org/10.3390/jcm9092994