Abstract:

Objective To explore the risk factors of veno⁃arterial extracorporeal membrane oxygenation （V⁃A ECMO）in treating cardiogenic shock. Methods The data of patients with cardiogenic shock treated with V⁃A ECMO in the Department of Cardiovascular Surgery，First Affiliated Hospital of Xi′an Jiaotong University from January 2016 to January 2021 were retrospectively analyzed. The patients were divided into the rehabilitation group and the death group according to their prognosis and the baseline data，and their clinical data and ECMO related parameters were recorded. The parameters with clinical significance and significant difference in univariate analysis were analyzed by multivariate Logistic regression analysis to investigate the risk factors of V ⁃A ECMO in treating the cardiogenic shock. Results A total of 77 patients were enrolled in the study，with 35 in the rehabilitation group and 42 in the death group. Compared with the rehabilitation group，the age，SOFA score，rates of CRRT and IABP were higher in the death group. Before VA⁃ECMO，the PLT counts were lower and the levels of Cr，BUN and lactate were higher in the death group，as compared with the rehabilitation group. By univariate Logistic regression analysis， there were significant differences in age and score of SOFA，use of CRRT and IABP，NT⁃proBNP，platelet，creati⁃ nine，urea and lactic acid. By multivariate Logistic regression analysis，the independent prognostic risk factors for the patients′ death were age and pre ⁃ ECMO platelet count. The higher the age（OR = 1.068，95% CI：1.027 ~ 1.110）was and the lower the pre⁃ECMO platelet counts（OR = 0.991，95%CI：0.984 ~ 0.998）were，the higher the death risk. Conclusion VA ⁃ECMO is an important mechanical therapy for patients with cardiogenic shock. The patients with advanced age，worse cardiac function，low PLT counts，renal insufficiency，use of IABP and/or CRRT may come out with poor prognosis. Lower platelet count is independent risk factor for the dearth，so increased platelet counts may be a target for improving prognosis of the cardiogenic shock patients undergoing VA⁃ECMO.

Key words:

cardiogenic shock, extracorporeal membrane oxygenation, risk factors