Diaphragm thickness modifications and associated factors during VA-ECMO for a cardiogenic shock: a cohort study

Moury, Pierre-Henri; Béhouche, Alexandre; Bailly, Sébastien; Durand, Zoé; Dessertaine, Géraldine; Pollet, Angelina; Jaber, Samir; Verges, Samuel; Albaladejo, Pierre

doi:10.1186/s13613-024-01264-8

Annals of Intensive Care

Table 1 Patients’ characteristics

From: Diaphragm thickness modifications and associated factors during VA-ECMO for a cardiogenic shock: a cohort study

Variable	Patient characteristics according to three groups of diaphragm thickness evolution (: stable, atrophy, increase) using a ultrasound method				Patient characteristics according to the absence or the presence of diaphragm atrophy using a ultrasound method
Variable	Increase, N = 4¹	Stable, N = 18¹	Atrophy, N = 7¹	p-value²	Non-atrophy, N = 22¹	Atrophy, N = 7¹	p-value³
Age (years)	67 [66, 68]	52 [48, 65]	55 [47, 66]	0.2	62 [48, 67]	55 [47, 66]	0.8
Sex (male)	4 [100%]	15 [83%]	6 [86%]	> 0.9	19 [86%]	6 [86%]	> 0.9
Weight (kg)	90 [83, 93]	80 [64, 98]	85 [73, 86]	0.7	81 [66, 96]	85 [73, 86]	> 0.9
Height (m)	1.79 [1.73, 1.84]	1.75 [1.7, 1.8]	1.7 [1.7, 1.75]	0.5	1.75 [1.7, 1.8]	1.7 [1.7, 1.75]	0.4
Body Mass Index	28 [25, 29]	26 [23, 30]	26 [25, 28]	0.9	26 [23, 29]	26 [25, 28]	0.8
SOFA	9 [7, 11]	9 [6, 10]	9 [8, 16]	0.5	9 [6, 10]	9 [8, 16]	0.3
Severe Acute Physiology Score II	47 [45, 49]	43 [36, 51]	47 [40, 62]	0.6	44 [41, 51]	47 [40, 62]	0.6
Cardiac arrest	0 (0%)	9 (50%)	3 (43%)	0.3	9 (41%)	3 (43%)	> 0.9
Cardiac surgery	2 (50%)	6 (33%)	4 (57%)	0.5	8 (36%)	4 (57%)	0.4
COPD	1 (25%)	1 (5.6%)	0 (0%)	0.3	2 (9.1%)	0 (0%)	> 0.9
Cancer	1 (25%)	1 (5.6%)	0 (0%)	0.3	2 (9.1%)	0 (0%)	> 0.9
Chronic kidney insufficiency	1 (25%)	0 (0%)	0 (0%)	0.14	1 (4.5%)	0 (0%)	> 0.9
Dialysis	1 (25%)	2 (11%)	2 (29%)	0.5	3 (14%)	2 (29%)	0.6
Fluid balance at inclusion (ml)	− 346 [− 718, 178]	− 273 [-900, 486]	304 [− 936, 1,227]	0.9	− 273 [− 900, 486]	304 [− 936, 1,227]	0.7
Weight balance J0 to last assessment (kg)	4 [2, 4]	0 [-4, 2]	− 1 [− 7, 3]	0.4	1 [− 3, 4]	− 1 [− 7, 3]	0.6
KDIGO
I	2 (50%)	13 (72%)	3 (43%)	0.4	15 (68%)	3 (43%)	0.4
II	0 (0%)	1 (5.6%)	0 (0%)		1 (4.5%)	0 (0%)
III	2 (50%)	4 (22%)	4 (57%)		6 (27%)	4 (57%)
Sepsis	0 (0%)	1 (5.6%)	1 (14%)	0.6	1 (4.5%)	1 (14%)	0.4
Number of MV days at day 7	2 [1, 4]	2 [1, 5]	6 [5, 7]	0.034	2 [1, 5]	6 [5, 7]	0.011
VA-ECMO parameters (All following parameters were averaged over the three first days)
VA-ECMO Flow (l/min)	2.9 [2.9, 3]	3.5 [2, 4]	4.5 [3, 5]	0.3	3.2 [2.5, 3.9]	4.5 [3, 5.3]	0.2
Sweep gas flow (l/min)	3 [2.7, 3.2]	3.1 [2.6, 4]	4.8 [3, 5]	0.12	3 [2.7, 4]	4.8 [3.3, 5]	0.045

Results are reported for patients according to their diaphragm evolution status at the end of patient follow-up. We divided the study population in three categories whether the diaphragm thickness presented a ≥ 10% decrease, increase or a stability from baseline to the last assessment
¹Median [interquartile range ]; n (%); ²Kruskal-Wallis rank sum test; Fisher’s exact test; ³Wilcoxon rank sum test; Fisher’s exact test; Wilcoxon rank sum exact test; BMI: Body mass index; COPD: Chronic Obstructive Pulmonary Disease; SAPS2: Simplified Acute Physiology Score 2;MV: Mechanical Ventilation; VA-ECMO: Veno-arterial extracorporeal membrane oxygenation; KDIGO: Kidney Disease Improving Global

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