Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2
Abstract Background Extracorporeal membrane oxygenation (ECMO) might be required as a treatment option in patients with critical pulmonary embolism (PE). However, the clinical features and outcomes of the use of ECMO for critical acute PE are still limited. The present study aimed to clarify the cli...
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2024-11-01
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| Online Access: | https://doi.org/10.1186/s40560-024-00755-x |
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| author | Kensuke Takabayashi Yugo Yamashita Takeshi Morimoto Ryuki Chatani Kazuhisa Kaneda Yuji Nishimoto Nobutaka Ikeda Yohei Kobayashi Satoshi Ikeda Kitae Kim Moriaki Inoko Toru Takase Shuhei Tsuji Maki Oi Takuma Takada Kazunori Otsui Jiro Sakamoto Yoshito Ogihara Takeshi Inoue Shunsuke Usami Po-Min Chen Kiyonori Togi Norimichi Koitabashi Seiichi Hiramori Kosuke Doi Hiroshi Mabuchi Yoshiaki Tsuyuki Koichiro Murata Hisato Nakai Daisuke Sueta Wataru Shioyama Tomohiro Dohke Ryusuke Nishikawa Koh Ono Takeshi Kimura On behalf of the COMMAND VTE Registry-2 Investigators |
| author_facet | Kensuke Takabayashi Yugo Yamashita Takeshi Morimoto Ryuki Chatani Kazuhisa Kaneda Yuji Nishimoto Nobutaka Ikeda Yohei Kobayashi Satoshi Ikeda Kitae Kim Moriaki Inoko Toru Takase Shuhei Tsuji Maki Oi Takuma Takada Kazunori Otsui Jiro Sakamoto Yoshito Ogihara Takeshi Inoue Shunsuke Usami Po-Min Chen Kiyonori Togi Norimichi Koitabashi Seiichi Hiramori Kosuke Doi Hiroshi Mabuchi Yoshiaki Tsuyuki Koichiro Murata Hisato Nakai Daisuke Sueta Wataru Shioyama Tomohiro Dohke Ryusuke Nishikawa Koh Ono Takeshi Kimura On behalf of the COMMAND VTE Registry-2 Investigators |
| author_sort | Kensuke Takabayashi |
| collection | DOAJ |
| description | Abstract Background Extracorporeal membrane oxygenation (ECMO) might be required as a treatment option in patients with critical pulmonary embolism (PE). However, the clinical features and outcomes of the use of ECMO for critical acute PE are still limited. The present study aimed to clarify the clinical characteristics, management strategies and outcomes of patients with acute PE requiring ECMO in the current era using data from a large-scale observational database. Methods We analyzed the data of the COMMAND VTE Registry-2: a physician-initiated, multicenter, retrospective cohort study enrolling consecutive patients with acute symptomatic venous thromboembolism (VTE). Among 2035 patients with acute symptomatic PE, there were 76 patients (3.7%) requiring ECMO. Results Overall, the mean age was 58.4 years, and 34 patients (44.7%) were men. Cardiac arrest or circulatory collapse at diagnosis was reported in 67 patients (88.2%). The 30-day incidence of all-cause death was 30.3%, which were all PE-related deaths. The 30-day incidence of major bleeding was 54.0%, and the vast majority of bleedings were procedure site-related bleeding events and surgery-related bleeding (22.4%). The 30-day incidence of all-cause death was 6.3% in 16 patients with surgical intervention, 43.8% in 16 patients with catheter intervention, 25.0% in 16 patients with thrombolytic therapy, and 39.3% in 28 patients with anticoagulation only. Conclusions The current large real-world VTE registry in Japan revealed clinical features and outcomes of critical acute PE requiring ECMO in the current era, which suggested several unmet needs for future clinical trials. |
| format | Article |
| id | doaj-art-1b4d37f854974e8e99a3ff0aa672077f |
| institution | Kabale University |
| issn | 2052-0492 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | Journal of Intensive Care |
| spelling | doaj-art-1b4d37f854974e8e99a3ff0aa672077f2024-11-10T12:10:27ZengBMCJournal of Intensive Care2052-04922024-11-011211910.1186/s40560-024-00755-xClinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2Kensuke Takabayashi0Yugo Yamashita1Takeshi Morimoto2Ryuki Chatani3Kazuhisa Kaneda4Yuji Nishimoto5Nobutaka Ikeda6Yohei Kobayashi7Satoshi Ikeda8Kitae Kim9Moriaki Inoko10Toru Takase11Shuhei Tsuji12Maki Oi13Takuma Takada14Kazunori Otsui15Jiro Sakamoto16Yoshito Ogihara17Takeshi Inoue18Shunsuke Usami19Po-Min Chen20Kiyonori Togi21Norimichi Koitabashi22Seiichi Hiramori23Kosuke Doi24Hiroshi Mabuchi25Yoshiaki Tsuyuki26Koichiro Murata27Hisato Nakai28Daisuke Sueta29Wataru Shioyama30Tomohiro Dohke31Ryusuke Nishikawa32Koh Ono33Takeshi Kimura34On behalf of the COMMAND VTE Registry-2 InvestigatorsDepartment of Cardiology, Hirakata Kohsai HospitalDepartment of Cardiovascular Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Clinical Epidemiology, Hyogo College of MedicineDepartment of Cardiovascular Medicine, Kurashiki Central HospitalDepartment of Cardiovascular Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Cardiology, Hyogo Prefectural Amagasaki General Medical CenterDivision of Cardiovascular Medicine, Toho University Ohashi Medical CenterDepartment of Cardiovascular Center, Osaka Red Cross HospitalDepartment of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical SciencesDepartment of Cardiovascular Medicine, Kobe City Medical Center General HospitalCardiovascular Center, The Tazuke Kofukai Medical Research Institute, Kitano HospitalDepartment of Cardiology, Kinki University HospitalDepartment of Cardiology, Japanese Red Cross Wakayama Medical CenterDepartment of Cardiology, Japanese Red Cross Otsu HospitalDepartment of Cardiology, Tokyo Women’s Medical UniversityDepartment of General Internal Medicine, Kobe University HospitalDepartment of Cardiology, Tenri HospitalDepartment of Cardiology and Nephrology, Mie University Graduate School of MedicineDepartment of Cardiology, Shiga General HospitalDepartment of Cardiology, Kansai Electric Power HospitalDepartment of Cardiology, Osaka Saiseikai Noe HospitalDivision of Cardiology, Faculty of Medicine, Nara Hospital, Kinki UniversityDepartment of Cardiovascular Medicine, Gunma University Graduate School of MedicineDepartment of Cardiology, Kokura Memorial HospitalDepartment of Cardiology, National Hospital Organization Kyoto Medical CenterDepartment of Cardiology, Koto Memorial HospitalDivision of Cardiology, Shimada General Medical CenterDepartment of Cardiology, Shizuoka City Shizuoka HospitalDepartment of Cardiovascular Medicine, Sugita Genpaku Memorial Obama Municipal HospitalDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto UniversityDepartment of Cardiovascular Medicine, Shiga University of Medical ScienceDivision of Cardiology, Kohka Public HospitalDepartment of Cardiovascular Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Cardiovascular Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Cardiology, Hirakata Kohsai HospitalAbstract Background Extracorporeal membrane oxygenation (ECMO) might be required as a treatment option in patients with critical pulmonary embolism (PE). However, the clinical features and outcomes of the use of ECMO for critical acute PE are still limited. The present study aimed to clarify the clinical characteristics, management strategies and outcomes of patients with acute PE requiring ECMO in the current era using data from a large-scale observational database. Methods We analyzed the data of the COMMAND VTE Registry-2: a physician-initiated, multicenter, retrospective cohort study enrolling consecutive patients with acute symptomatic venous thromboembolism (VTE). Among 2035 patients with acute symptomatic PE, there were 76 patients (3.7%) requiring ECMO. Results Overall, the mean age was 58.4 years, and 34 patients (44.7%) were men. Cardiac arrest or circulatory collapse at diagnosis was reported in 67 patients (88.2%). The 30-day incidence of all-cause death was 30.3%, which were all PE-related deaths. The 30-day incidence of major bleeding was 54.0%, and the vast majority of bleedings were procedure site-related bleeding events and surgery-related bleeding (22.4%). The 30-day incidence of all-cause death was 6.3% in 16 patients with surgical intervention, 43.8% in 16 patients with catheter intervention, 25.0% in 16 patients with thrombolytic therapy, and 39.3% in 28 patients with anticoagulation only. Conclusions The current large real-world VTE registry in Japan revealed clinical features and outcomes of critical acute PE requiring ECMO in the current era, which suggested several unmet needs for future clinical trials.https://doi.org/10.1186/s40560-024-00755-xECMOAcute pulmonary embolismSurgical pulmonary embolectomyPrognosisMortalityMajor bleeding |
| spellingShingle | Kensuke Takabayashi Yugo Yamashita Takeshi Morimoto Ryuki Chatani Kazuhisa Kaneda Yuji Nishimoto Nobutaka Ikeda Yohei Kobayashi Satoshi Ikeda Kitae Kim Moriaki Inoko Toru Takase Shuhei Tsuji Maki Oi Takuma Takada Kazunori Otsui Jiro Sakamoto Yoshito Ogihara Takeshi Inoue Shunsuke Usami Po-Min Chen Kiyonori Togi Norimichi Koitabashi Seiichi Hiramori Kosuke Doi Hiroshi Mabuchi Yoshiaki Tsuyuki Koichiro Murata Hisato Nakai Daisuke Sueta Wataru Shioyama Tomohiro Dohke Ryusuke Nishikawa Koh Ono Takeshi Kimura On behalf of the COMMAND VTE Registry-2 Investigators Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 Journal of Intensive Care ECMO Acute pulmonary embolism Surgical pulmonary embolectomy Prognosis Mortality Major bleeding |
| title | Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 |
| title_full | Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 |
| title_fullStr | Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 |
| title_full_unstemmed | Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 |
| title_short | Clinical characteristics and short-term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation: from the COMMAND VTE Registry-2 |
| title_sort | clinical characteristics and short term outcomes of patients with critical acute pulmonary embolism requiring extracorporeal membrane oxygenation from the command vte registry 2 |
| topic | ECMO Acute pulmonary embolism Surgical pulmonary embolectomy Prognosis Mortality Major bleeding |
| url | https://doi.org/10.1186/s40560-024-00755-x |
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