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Inodilators May Improve the In-Hospital Mortality of Patients with Cardiogenic Shock Undergoing Veno-Arterial Extracorporeal Membrane Oxygenationopen access

Authors
Kim, MijooSeong, Seok-WooSong, Pil SangJeong, Jin-OkYang, Jeong HoonGwon, Hyeon-CheolKo, Young-GukYu, Cheol WoongChun, Woo JungJang, Woo JinKim, Hyun-JoongBae, Jang-WhanKwon, Sung UkLee, Hyun-JongLee, Wang SooPark, Sang-DonCho, Sung SooPark, Jae-Hyeong
Issue Date
Sep-2022
Publisher
MDPI
Keywords
extracorporeal membrane oxygenation; cardiogenic shock; dobutamine; milrinone
Citation
JOURNAL OF CLINICAL MEDICINE, v.11, no.17
Journal Title
JOURNAL OF CLINICAL MEDICINE
Volume
11
Number
17
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/58789
DOI
10.3390/jcm11174958
ISSN
2077-0383
2077-0383
Abstract
Although inodilators (dobutamine and milrinone) are widely used empirically for cardiogenic shock (CS), the efficacy of inodilators for patients with CS undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is controversial. We evaluated the effects of inodilators on clinical outcomes using the RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock; NCT02985008) registry. We selected and analyzed the clinical outcomes of 496 patients who underwent VA-ECMO and did or did not receive inodilators. Of the 496 patients, 257 (51.8%) died during hospitalization. We selected 191 matched pairs to adjust for baseline clinical characteristics after 1:1 propensity score matching (PSM). The univariate and multivariate analyses showed that the inodilator group had significantly lower in-hospital mortality than the no-inodilator group (unadjusted hazard ratio [HR], 0.768; 95% confidence interval [CI], 0.579-1.018; p = 0.066, adjusted HR, 0.702; 95% CI, 0.552-0.944; p = 0.019). For patients with CS undergoing VA-ECMO, inodilators may improve clinical outcomes.
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