Evidence map›Paper›PMID 38436727›Full record

ArticleIntensive care medicine2024

Venoarterial extracorporeal membrane oxygenation in immunocompromised patients with cardiogenic shock: a cohort study and propensity-weighted analysis.

Quentin Moyon, Félicien Triboulet, Jean Reuter, Guillaume Lebreton, Amandine Dorget, Marylou Para, Juliette Chommeloux, Jules Stern, Marc Pineton de Chambrun, Guillaume Hékimian and 4 more

Abstract read
PubMed Publisher
In one paragraph

Article in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Quentin MoyonAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Félicien TribouletAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Jean ReuterAssistance Publique des Hopitaux de Paris, Medical and Infectious Diseases Intensive Care Unit, Bichat Hospital, Paris Diderot University, Sorbonne Paris Cité, INSERM/Paris Diderot University, Paris, France.
Guillaume LebretonAssistance Publique des Hopitaux de Paris, Service de Chirurgie Cardiaque, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Amandine DorgetAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Marylou ParaAssistance Publique Des Hopitaux de Paris, Bichat Hospital, Service de Chirurgie Cardiaque, Paris Diderot University, Sorbonne Paris Cité, INSERM/Paris Diderot University, Paris, France.
Juliette ChommelouxAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Jules SternAssistance Publique Des Hopitaux de Paris, Department of Anesthesiology and Critical Care Medicine, Bichat Hospital, Paris Diderot University, Sorbonne Paris Cité, INSERM/Paris Diderot University, Paris, France.
Marc Pineton de ChambrunAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Guillaume HékimianAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Charles-Edouard LuytAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Alain CombesAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
Romain SonnevilleAssistance Publique des Hopitaux de Paris, Medical and Infectious Diseases Intensive Care Unit, Bichat Hospital, Paris Diderot University, Sorbonne Paris Cité, INSERM/Paris Diderot University, Paris, France.
Matthieu SchmidtAssistance Publique des Hopitaux de Paris, Service de Médecine Intensive-Réanimation, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, 75013, Paris, France. matthieu.schmidt@aphp.fr.ORCID 0000-0002-2931-4412
Inserm · FRAssistance Publique – Hôpitaux de Paris · FRSorbonne Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe outcomes of immunocompromised patients with cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) are seldom documented, making ECMO candidacy decisions challenging. This study aims (1) to report outcomes of immunocompromised patients treated with VA-ECMO, (2) to identify pre-ECMO predictors of 90-day mortality, (3) to assess the impact of immunodepression on 90-day mortality, and (4) to describe the main ECMO-related complications.

methodsThis is a retrospective, propensity-weighted study conducted in two French experienced ECMO centers.

resultsFrom January 2006 to January 2022, 177 critically ill immunocompromised patients (median (interquartile range, IQR) age 49 (32-60) years) received VA-ECMO. The main causes of immunosuppression were long-term corticosteroids/immunosuppressant treatment (29%), hematological malignancy (26%), solid organ transplant (20%), and solid tumor (13%). Overall 90-day and 1-year mortality were 70% (95% confidence interval (CI) 63-77%) and 75% (95% CI 65-79%), respectively. Older age and higher pre-ECMO lactate were independently associated with 90-day mortality. Across immunodepression causes, 1-year mortality ranged from 58% for patients with infection by human immunodeficiency virus (HIV) or asplenia, to 89% for solid organ transplant recipients. Hemorrhagic and infectious complications affected 39% and 54% of patients, while more than half the stay in intensive care unit (ICU) was spent on antibiotics. In a propensity score-weighted model comparing the 177 patients with 942 non-immunocompromised patients experiencing cardiogenic shock on VA-ECMO, immunocompromised status was independently associated with a higher 90-day mortality (odds ratio 2.53, 95% CI 1.72-3.79).

conclusionImmunocompromised patients undergoing VA-ECMO treatment face an unfavorable prognosis, with higher 90-day mortality compared to non-immunocompromised patients. This underscores the necessity for thorough evaluation and careful selection of ECMO candidates within this frail population.

Indexed as

Extracorporeal Membrane OxygenationShock, CardiogenicCohort StudiesHumansImmunocompromised HostMiddle AgedRetrospective StudiesCardiogenic shockExtracorporeal membrane oxygenationImmunocompromised status

Identifiers

PMID38436727
OpenAlexW4392429672

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.