Citations 2
Platelet transfusion is associated with 90‐day and 1‐year mortality for adult patients requiring veno‐arterial extracorporeal membrane oxygenation
Esper, Stephen A. , Wallisch, William John , Ryan, John P. , Sánchez, Pablo Menéndez , Sciortino, Christopher M., Murray, Holt , Arlia, Peter, D’Cunha, Jonathan, Mahajan, Aman , Triulzi, Darrell J., Esper, S A , Sanchez, Pablo, Subramaniam, Kathirvel
Vox Sanguinis | November 20, 2020 | Volume: 116 | Issue: 4 | Pages: 440-450
BackgroundStudies examining one‐year mortality respecting component blood transfusion are sparse. We hypothesize that component blood product transfusions are negatively associated with 90‐day and 1‐year survival for all patients requiring veno‐arterial (VA) or veno‐venous (VV) ECMO.Study Design and MethodsThis was an IRB‐approved retrospective cohort analysis of 676 consecutive patients requiring ECMO at the University of Pittsburgh between 2005 and 2016. Patients were analysed both as an entire cohort and as two subsets with respect to ECMO modality (VA vs. VV). Additional data collected and analysed included patient characteristics, laboratory values and blood product transfusion.ResultsMultivariable analysis revealed that platelet transfusion was associated with 90‐day mortality (OR: 1·05, P = 0·037) and one‐year mortality for the entire cohort (OR = 1·05, P = 0·046,). Platelet transfusion volume was also associated with mortality in the VA‐ECMO subset of patients at both 90 days (OR = 1·08, P = 0·03) and one year (OR: 1·11, P = 0·014). Age, peak International Normalized Raton ECMO, nadir haemoglobin (on ECMO) and final haemoglobin (after ECMO) were significantly associated with mortality for patients requiring VA‐ECMO. For VV‐ECMO patients, age, INR and peak creatinine on ECMO were associated with mortality. No individual component blood product was associated with one‐year mortality for patients requiring VV‐ECMO.ConclusionPlatelet transfusion was associated with increased 90‐day and 1‐year mortality for patients requiring VA‐ECMO.
Clinical neurocardiology defining the value of neuroscience‐based cardiovascular therapeutics
Shivkumar, Kalyanam , Ajijola, Olujimi A. , Anand, Inder S. , Armour, J. Andrew, Chen, Peng‐Sheng , Esler, Murray , Ferrari, Gaetano Maria De , Fishbein, Michael C. , Harper, Ronald M. , Joyner, Michael J. , Khalsa, Sahib S. , Lane, Richard D. , Mahajan, Aman , Po, Sunny S. , Valderrábano, Miguel , Vaseghi, Marmar , Goldberger, Jeffrey J , Kumar, Rajesh , Schwartz, Peter J. , Somers, Virend K. , Zipes, Douglas P. , Shivkumar, Kalyanam , Anand, Inder S , Joyner, Michael J , Khalsa, Sahib S
The Journal of Physiology | April 27, 2016 | Volume: 594 | Issue: 14 | Pages: 3911-3954
AbstractThe autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology of many cardiovascular diseases. As such, the value of neuroscience‐based cardiovascular therapeutics is increasingly evident. This White Paper reviews the current state of understanding of human cardiac neuroanatomy, neurophysiology, pathophysiology in specific disease conditions, autonomic testing, risk stratification, and neuromodulatory strategies to mitigate the progression of cardiovascular diseases.