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Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation
BACKGROUND: The presence of Nucleated Red Blood Cells (NRBCs) in critically ill patients is associated with higher mortality and poor prognosis. Although patients on extracorporeal support such as veno-venous or veno-arterial extracorporeal membrane oxygenation (VV/VA-ECMO) are severely ill, NRBCs h...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405375/ https://www.ncbi.nlm.nih.gov/pubmed/37550743 http://dx.doi.org/10.1186/s40001-023-01243-y |
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author | Loesaus, Sebastian Zahn, Peter Konrad Bechtel, Matthias Strauch, Justus Thomas Buchwald, Dirk Baumann, Andreas Berres, Dinah Maria |
author_facet | Loesaus, Sebastian Zahn, Peter Konrad Bechtel, Matthias Strauch, Justus Thomas Buchwald, Dirk Baumann, Andreas Berres, Dinah Maria |
author_sort | Loesaus, Sebastian |
collection | PubMed |
description | BACKGROUND: The presence of Nucleated Red Blood Cells (NRBCs) in critically ill patients is associated with higher mortality and poor prognosis. Although patients on extracorporeal support such as veno-venous or veno-arterial extracorporeal membrane oxygenation (VV/VA-ECMO) are severely ill, NRBCs have rarely been investigated regarding their predictive value so far. METHODS: As part of a retrospective study, we examined all cardiothoracic surgery patients from July 2019 to September 2020 who received ECMO treatment during their inpatient stay. The aim of this study was to investigate the occurrence of NRBCs during ECMO support in terms of their predictive value for mortality. RESULTS: In total 30 patients (age at admission: 62.7 ± 14.3 year; 26 male; ECMO duration: 8.5 ± 5.1 days; ICU duration: 18.0 ± 14.5 days) were included. 16 patients (53.3%) died during their inpatient stay. There were no significant differences in demographic characteristics between VA- or VV- ECMO patients. NRBCs occurred in all patients while under ECMO support. NRBC value was significant higher in those who died (2299.6 ± 4356.6 µl) compared to the surviving patients (133.6 ± 218.8 µl, p < 0.001). Univariate analysis found that patients with a cutoff value of ≥ 270 NRBCs/µl during ECMO support were 39 times more likely to die (OR 39.0, 95% CI 1.5–997.5, p < 0.001). 12 out of 13 patients (92.3%) with ≥ 270 NRBCs/µl died. The area under the curve (AUC) of the receiver operating characteristic curve was 0.85 (95% CI 0.69–0.96) with a sensitivity of 75.0% and a specificity of 92.9%. CONCLUSION: NRBCs appear to be an accurate biomarker for mortality in patients with ECMO support. They may be helpful in deciding if therapy becomes futile. Trial registration DRKS00023626 (December 20th 2020). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40001-023-01243-y. |
format | Online Article Text |
id | pubmed-10405375 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104053752023-08-08 Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation Loesaus, Sebastian Zahn, Peter Konrad Bechtel, Matthias Strauch, Justus Thomas Buchwald, Dirk Baumann, Andreas Berres, Dinah Maria Eur J Med Res Research BACKGROUND: The presence of Nucleated Red Blood Cells (NRBCs) in critically ill patients is associated with higher mortality and poor prognosis. Although patients on extracorporeal support such as veno-venous or veno-arterial extracorporeal membrane oxygenation (VV/VA-ECMO) are severely ill, NRBCs have rarely been investigated regarding their predictive value so far. METHODS: As part of a retrospective study, we examined all cardiothoracic surgery patients from July 2019 to September 2020 who received ECMO treatment during their inpatient stay. The aim of this study was to investigate the occurrence of NRBCs during ECMO support in terms of their predictive value for mortality. RESULTS: In total 30 patients (age at admission: 62.7 ± 14.3 year; 26 male; ECMO duration: 8.5 ± 5.1 days; ICU duration: 18.0 ± 14.5 days) were included. 16 patients (53.3%) died during their inpatient stay. There were no significant differences in demographic characteristics between VA- or VV- ECMO patients. NRBCs occurred in all patients while under ECMO support. NRBC value was significant higher in those who died (2299.6 ± 4356.6 µl) compared to the surviving patients (133.6 ± 218.8 µl, p < 0.001). Univariate analysis found that patients with a cutoff value of ≥ 270 NRBCs/µl during ECMO support were 39 times more likely to die (OR 39.0, 95% CI 1.5–997.5, p < 0.001). 12 out of 13 patients (92.3%) with ≥ 270 NRBCs/µl died. The area under the curve (AUC) of the receiver operating characteristic curve was 0.85 (95% CI 0.69–0.96) with a sensitivity of 75.0% and a specificity of 92.9%. CONCLUSION: NRBCs appear to be an accurate biomarker for mortality in patients with ECMO support. They may be helpful in deciding if therapy becomes futile. Trial registration DRKS00023626 (December 20th 2020). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40001-023-01243-y. BioMed Central 2023-08-07 /pmc/articles/PMC10405375/ /pubmed/37550743 http://dx.doi.org/10.1186/s40001-023-01243-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Loesaus, Sebastian Zahn, Peter Konrad Bechtel, Matthias Strauch, Justus Thomas Buchwald, Dirk Baumann, Andreas Berres, Dinah Maria Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title | Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title_full | Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title_fullStr | Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title_full_unstemmed | Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title_short | Nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
title_sort | nucleated red blood cells are a predictor of mortality in patients under extracorporeal membrane oxygenation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405375/ https://www.ncbi.nlm.nih.gov/pubmed/37550743 http://dx.doi.org/10.1186/s40001-023-01243-y |
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