Total cholesterol and Intensive Care survival in patients treated with
Veno-Arterial Extracorporeal Life Support; A preliminary single-centre
experience
Abstract
Objective Veno-Arterial Extra Corporeal Life Support (VA ECLS) is widely
used as an effective device for patients in cardiogenic shock. The need
for predictive markers that daily guide physicians in the evaluation of
these patients could be of great value. Our aim was to investigate the
role of cholesterol value during VA ECLS in predicting the Intensive
Care Unit (ICU) survival. Methods Between January 2013 and November
2019, 67 patients with VA ECLS due to cardiogenic shock were included in
this study. Demographic data, laboratory values, ICU data and outcomes
were collected. Cholesterol was measured during morning routine blood
samples. The minimal cholesterol value during the ICU stay was
registered. Groups were stratified by minimal cholesterol cut-off point
of 2.0 mmol/L. Logistic regression analysis were performed to identify
variables associated with ICU survival. Results The ECLS duration was
not significantly different (p=0.36) between the non-survivors (median
5.0 (2.0-7.5) days) and survivors (median 6.0 (1.8-12.0) days). The
minimal cholesterol level was significantly lower (p=0.04) in
non-survivors group (1.54 (1.00-1.87) mmol/L) compared to survivors
(1.85 (1.38-2.24) mmol/L). By using logistic regression analysis,
minimal cholesterol level of ≥2.0 mmol/L was associated with a higher
ICU survival (p=0.02; OR 3.77; 95% CI 1.20-11.81). Conclusion
Cholesterol level could be an additional marker for ICU survival of
patients with cardiogenic shock on VA ECLS. A larger cohort of patients
is necessary to determine total cholesterol as a specific risk factor
for survival in these patients.