Evidence map›Paper›PMID 36717346›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2024

Worse survival in patients with right ventricular dysfunction and COVID-19-associated acute respiratory distress requiring extracorporeal membrane oxygenation: A multicenter study from the ORACLE Group.

Michael T Cain, Lauren J Taylor, Kathryn Colborn, Nicholas R Teman, Jordan Hoffman, Kirby P Mayer, Eric W Etchill, Carla M Sevin, Sruthi Jaishankar, Raj Ramanan and 5 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 38% 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

4 citing papers in PubMed, 7 citations in OpenAlex.

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

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 1 country.

Michael T CainDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.
Lauren J TaylorDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.
Kathryn ColbornDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.
Nicholas R TemanDivision of Cardiothoracic Surgery, Department of Surgery, University of Virginia, Charlottesville, Va.
Jordan HoffmanDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo.
Kirby P MayerDepartment of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, Ky.
Eric W EtchillDivision of Cardiothoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Md.
Carla M SevinDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, Tenn.
Sruthi JaishankarUniversity of Pittsburgh School of Medicine, Pittsburgh, Pa.
Raj RamananDepartment of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pa.
Kyle EnfieldDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, Va.
Joseph B ZwischenbergerDivision of Cardiothoracic Surgery, Department of Surgery, University of Kentucky, Lexington, Ky.
Sarah E JolleyDivision of Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colo.
Jessica Y RoveDivision of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colo. Electronic address: jessica.rove@cuanschutz.edu.
ORACLE group
University of Colorado Anschutz Medical Campus · USUniversity of Kentucky · USUniversity of Pittsburgh · USUniversity of Virginia · USJohns Hopkins University · USVanderbilt University · US

Funding

Cellular and Physical Function Outcomes Leading to Failed Muscle Recovery After Critical IllnessK23AR079583 · NIAMS · UNIVERSITY OF KENTUCKY · PI Kirby P Mayer · 2022 to 2026
$744k
Prevalence of ICU-Acquired Myopathy in Patients with Alcohol Use DisordersK23AA026315 · NIAAA · UNIVERSITY OF COLORADO DENVER · PI JOLLEY, SARAH E · 2018 to 2022
$696k
NIAAA NIH HHS K23 AA026315NIAMS NIH HHS K23 AR079583NIMHD NIH HHS L32 MD017732
6 · The paper itself

Abstract

objectiveWe sought to determine the impact of right ventricular dysfunction on the outcomes of mechanically ventilated patients with COVID-19 requiring veno-venous extracorporeal membrane oxygenation.

methodsSix academic centers conducted a retrospective analysis of mechanically ventilated patients with COVID-19 stratified by support with veno-venous extracorporeal membrane oxygenation during the first wave of the pandemic (March to August 2020). Echocardiograms performed for clinical indications were reviewed for right and left ventricular function. Baseline characteristics, hospitalization characteristics, and survival were compared.

resultsThe cohort included 424 mechanically ventilated patients with COVID-19, 126 of whom were cannulated for veno-venous extracorporeal membrane oxygenation. Right ventricular dysfunction was observed in 38.1% of patients who received extracorporeal membrane oxygenation and 27.4% of patients who did not receive extracorporeal membrane oxygenation with an echocardiogram. Biventricular dysfunction was observed in 5.5% of patients who received extracorporeal membrane oxygenation. Baseline patient characteristics were similar in both the extracorporeal membrane oxygenation and non-extracorporeal membrane oxygenation cohorts stratified by the presence of right ventricular dysfunction. In the extracorporeal membrane oxygenation cohort, right ventricular dysfunction was associated with increased inotrope use (66.7% vs 24.4%, P < .001), bleeding complications (77.1% vs 53.8%, P = .015), and worse survival independent of left ventricular dysfunction (39.6% vs 64.1%, P = .012). There was no significant difference in days ventilated before extracorporeal membrane oxygenation, length of hospital stay, hours on extracorporeal membrane oxygenation, duration of mechanical ventilation, vasopressor use, inhaled pulmonary vasodilator use, infectious complications, clotting complications, or stroke. The cohort without extracorporeal membrane oxygenation cohort demonstrated no statistically significant differences in in-hospital outcomes.

conclusionsThe presence of right ventricular dysfunction in patients with COVID-19-related acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation was associated with increased in-hospital mortality. Additional studies are required to determine if mitigating right ventricular dysfunction in patients requiring veno-venous extracorporeal membrane oxygenation improves mortality.

Indexed as

COVID-19Extracorporeal Membrane OxygenationRespiratory Distress SyndromeVentricular Dysfunction, RightHumansRetrospective StudiesCOVID-19extracorporeal membrane oxygenationright ventricular dysfunction

Identifiers

PMID36717346
PMCPMC9767877
OpenAlexW4313549232

What Socratic 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 Socratic graph.