초록접수 현황
| 17F-072 | 구연 미채택시 포럼 발표 |
Predictive Value of Procalcitonin for Infection and Survival in Adult Cardiogenic ECMO
Do Wan Kim, Gwan Sic Kim, Kyo Seon Lee, Yo Chun Jung, Sang Gi Oh, Sang Yun Song, KooK Joo Na, Byoung Hee Ahn, Bong Suk Oh, In Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
Purpose : Procalcitonin (PCT) is the predictive marker for occurrence of bacterial infection and cessation of antibiotics in critically ill patients. Unusual increase of PCT, regardless of infection occurrence, has happened during extracorporeal membrane oxygenation (ECMO) support. We evaluate the trend and predictive value of PCT level during adult cardiogenic ECMO.
Methods : We reviewed the clinical records of 43 adult cardiogenic shock patients undergoing venoarterial ECMO (VA-ECMO) support from January 2014 to December 2016. Exclusion criteria were patients with less than 18 years old, pre-ECMO infection and less than 48 hours support.
Results : Mean patient age was 61.4 ± 15.4 years and 15 (15.1%) patients were female. The mean duration of ECMO support was 7.3 ± 6.7 days. The rates of successful ECMO weaning and survival to discharge were 51.2% (n=22) and 48.8% (n=21), respectively. There were 13 nosocomial infections in 9 (20.9%) patients. Peak PCT levels (mean 25.6 ± 9.4ng/ml) are reached within 48 hours after initiation of ECMO support, and within one week, it decreases to 5 or less. The change of PCT levels was no use to predict the occurrence of nosocomial infection during ECMO run (p>0.05). However PCT level (more than 10ng/ml) within first one week during ECMO support was significantly associated with mortality (p<0.003).
Conclusion : The level of PCT is of no use in prediction of the new infection during ECMO support. But higher PCT levels suggest the significantly higher mortality within first week of ECMO run.
Methods : We reviewed the clinical records of 43 adult cardiogenic shock patients undergoing venoarterial ECMO (VA-ECMO) support from January 2014 to December 2016. Exclusion criteria were patients with less than 18 years old, pre-ECMO infection and less than 48 hours support.
Results : Mean patient age was 61.4 ± 15.4 years and 15 (15.1%) patients were female. The mean duration of ECMO support was 7.3 ± 6.7 days. The rates of successful ECMO weaning and survival to discharge were 51.2% (n=22) and 48.8% (n=21), respectively. There were 13 nosocomial infections in 9 (20.9%) patients. Peak PCT levels (mean 25.6 ± 9.4ng/ml) are reached within 48 hours after initiation of ECMO support, and within one week, it decreases to 5 or less. The change of PCT levels was no use to predict the occurrence of nosocomial infection during ECMO run (p>0.05). However PCT level (more than 10ng/ml) within first one week during ECMO support was significantly associated with mortality (p<0.003).
Conclusion : The level of PCT is of no use in prediction of the new infection during ECMO support. But higher PCT levels suggest the significantly higher mortality within first week of ECMO run.
첨부파일 : PCT - figure.docx
책임저자: In Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
발표자: Do Wan Kim, E-mail : maskjoa@naver.com