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Table 3 MCS flow, and changes in hemodynamic and oxygenation parameters before and after iNO therapy initiation

From: Impact of inhaled nitric oxide therapy in patients with cardiogenic shock treated with veno-arterial extracorporeal membrane oxygenation combined with Impella: a retrospective cohort study

 

All cases (n = 48)

With iNO therapy (n = 25)

Without iNO therapy (n = 23)

P value

iNO therapy

 Days to iNO initiation (days)

1.5 ± 1.3

 Duration of iNO (days)

13.1 ± 8.1

 Maximum dose of iNO (ppm)

21.2 ± 6.0

MCS

 VA-ECMO flow (L/min)

  -Pre

2.1 (2.3–3.6)

3.1 (2.0–3.3)

3.4 (2.7–3.9)

0.21

  -Post 24 h

2.9 (2.3–3.6)

2.7 (2.2–3.3)

3.2 (2.8–3.8)

0.23

  Impella CP, n (%)

42 (87.5)

23 (92.0)

19 (82.6)

0.25

Impella P levels

 -Pre

4.0 (2.0–5.8)

4.0 (2.5–6.0)

3.0 (2.0–5.0)

0.32

 -Post 24 h

4.0 (2.0–6.0)

4.0 (2.0–6.0)

4.0 (2.0–5.5)

0.77

Impella flow (L/min)

 -Pre

1.7 (1.3–2.3)

1.5 (1.3–2.3)

1.9 (1.3–2.3)

0.80

 -Post 24 h

2.0 (1.4–2.6)

2.0 (1.4–2.9)

2.1 (1.5–2.4)

0.46

Hemodynamics

 MAP (mmHg)

  -Pre

77 (66–86)

78 (71–89)

72 (50–85)

0.08

  -Post 24 h

75 (66–88)

79 (66–88)

73 (64–89)

0.53

CO (L/min)

 -Pre*a

2.3 (1.5–3.2)

2.3 (1.3–3.8)

2.2 (1.8–3.2)

0.69

 -Post 24 h*b

2.7 (2.0–3.5)

3.2 (1.8–3.8)

2.6 (1.9–3.2)

0.65

Mean PA pressure (mmHg)

 -Pre

18 (15–24)

18 (16–24)

17 (12–23)

0.35

 -Post 24 h

19 (14–21)

19 (15–22)

15 (13–21)

0.25

RA pressure (mmHg)

 -Pre

10 (7–13)

11 (8–13)

9 (6–15)

0.95

 -Post 24 h

9 (6–12)

9 (7–12)

9 (4–13)

0.96

PAPi score

 -Pre

1.1 (0.6–1.7)

1.0 (0.7–1.5)

1.6 (0.5–2.1)

0.14

 -Post 24 h

1.5 (1.0–2.3)

1.5 (1.0–2.0)

1.6 (0.9–2.7)

0.65

Oxygenation

 P/F ratio (patient)

  -Pre

329 (216–459)

312 (189–456)

340 (250–466)

0.86

  -Post 24 h

308 (196–419)

370 (199–408)

255 (190–428)

0.77

P/F ratio (VA-ECMO)

 -Pre

433 (336–502)

467 (362–547)

369 (329–456)

0.08

 -Post 24 h

452 (360–538)

473 (386–563)

410 (243–535)

0.21

  1. MCS mechanical circulatory support, VA-ECMO veno-arterial extracorporeal oxygenation, MAP mean arterial pressure, CO cardiac output, PA pulmonary artery, RA right atrial, PAPi pulmonary artery pulsatility index, P/F ratio PaO2/FiO2 ratio, iNO inhaled nitric oxide
  2. *a: data were available for 12 patients with iNO therapy and 8 patients without iNO therapy
  3. *b: data were available for 13 patients with iNO therapy and 7 patients without iNO therapy