In a recent edition of this Journal, an intriguing study was published which examined
the association between (development of) pulmonary congestion (PC) and mortality in
patients with post-cardiotomy cardiogenic shock requiring extracorporeal membrane
oxygenation (ECMO). [
[1]
] Distelmaier and colleagues observed in 266 patients that presence of PC on days 3
and 5 —but not day 0— after ECMO initiation was negatively associated with survival.
We were struck by the apparent disparity in impact of PC on mortality between first
and subsequent days. We are concerned that two methodological issues might have caused
this apparent difference; selection (survivor) bias and confounding.To read this article in full you will need to make a payment
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References
- Interdependence of VA-ECMO output, pulmonary congestion and outcome after cardiac surgery.Eur J Intern Med. 2020; 81: 67-70
- Duration of extracorporeal membrane oxygenation support and survival in cardiovascular surgery patients.J Thorac Cardiovasc Surg. 2018; 155: 2471-2476
- Index event bias as an explanation for the paradoxes of recurrence risk research.JAMA. 2011; 305: 822-823
Article info
Publication history
Published online: December 19, 2020
Accepted:
December 9,
2020
Received:
November 15,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
