Early hepatic dysfunction has previously been reported to be an independent risk factor for poor prognosis in critical ill patients. Hepatic and bowel ischemic complication are unfortunately common in patients that require venoarterial (VA) ECMO therapy following a cardiac surgery procedure. It is unclear if biomarkers of liver dysfunction predict outcomes in these patients. Therefore, in this single centre, retrospective study, the Authors sought to determine the predictive value of liver function variables on all-cause mortality in 240 patients requiring venoarterial (VA) ECMO therapy following a cardiac surgery procedure. The Authors have found that elevated values of alkaline phosphatase and total bilirubin were sensitive parameters for predicting the short-term and long-term outcomes in postoperative cardiac patients requiring VA-ECMO. The Authors have concluded that these may represent important biomarkers in the decision-making algorithm in the implementation of ECMO.
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Liver function predicts survival in patients undergoing extracorporeal membrane oxygenation following cardiovascular surgery
Source: Critical Care 2016 20:57
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Author(s): Christian Roth, Lore Schrutka, Christina Binder, Lukas Kriechbaumer, Gottfried Heinz, Irene M. Lang, Gerald Maurer, Herbert Koinig, Barbara Steinlechner, Alexander Niessner, Klaus Distelmaier and Georg Goliasch
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This is a single centre registry with a reasonable sample size examining the utility of commonly used liver function may assist in risk-prediction with the implementation VA-ECMO. Further larger sample size analyses are required to further validate the use of this commonly obtained biomarker.