{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:06:24Z","timestamp":1785575184231,"version":"3.56.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4ts-Herzzentrum Freiburg - Bad Krozingen GmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Patients with cardiogenic shock or cardiac arrest undergoing venoarterial extracorporeal membrane oxygenation (V-A ECMO) frequently present with blood glucose levels out of normal range. The clinical relevance of such findings in the context of V-A ECMO is unknown. We therefore investigated the prognostic relevance of blood glucose at time of cannulation for V-A ECMO.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a single-center retrospective registry study. All patients receiving V-A ECMO from October 2010 to January 2020 were included if blood glucose level at time of cannulation were documented. Patients were divided in five groups according to the initial blood glucose level ranging from hypoglycemic (&lt;\u200980\u00a0mg\/dl), normoglycemic (80\u2013140\u00a0mg\/dl), to mild (141-240\u00a0mg\/dl), moderate (241\u2013400\u00a0mg\/dl), and severe (&gt;\u2009400\u00a0mg\/dl) hyperglycemia, respectively. Clinical presentation, arterial blood gas analysis, and survival were compared between the groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>392 patients met inclusion criteria. Median age was 62\u00a0years (51.5\u201370.0), SAPS II at admission was 54 (43.5\u201363.0), and 108\/392 (27.6%) were female. 131\/392 were discharged alive (hospital survival 33.4%). At time of cannulation, survivors had higher pH, hemoglobin, calcium, bicarbonate but lower potassium and lactate levels compared to non-survivors (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Outcome of patients diagnosed with particularly high (&gt;\u2009400\u00a0mg\/dl) and low (&lt;\u200980\u00a0mg\/dl) blood glucose at time of V-A ECMO cannulation, respectively, was worse compared to patients with normoglycemic, mildly or moderately elevated values (<jats:italic>p<\/jats:italic>\u2009=\u20090.02). Glucose was independently associated with poor outcome after adjustment for other predictors of survival and persisted in all investigated subgroups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Arterial blood glucose at time of V-A ECMO cannulation predicts in-hospital survival of patients with cardiac shock or after ECPR. Whether dysglycemia represents a potential therapeutic target requires further evaluation in prospective studies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-021-01862-7","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T06:03:02Z","timestamp":1620108182000},"page":"1484-1492","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Admission blood glucose level and outcome in patients requiring venoarterial extracorporeal membrane oxygenation"],"prefix":"10.1007","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7309-7729","authenticated-orcid":false,"given":"Xavier","family":"Bemtgen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Rilinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"J\u00e4ckel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viviane","family":"Zotzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Supady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Benk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Bode","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Wengenmayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Lother","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawid L.","family":"Staudacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"key":"1862_CR1","doi-asserted-by":"publisher","first-page":"8423","DOI":"10.1038\/s41598-020-65498-9","volume":"10","author":"D Duerschmied","year":"2020","unstructured":"Duerschmied D, Zotzmann V, Rieder M, Bemtgen X, Biever PM, Kaier K et al (2020) Myocardial infarction type 1 is frequent in refractory out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR). Sci Rep 10:8423","journal-title":"Sci Rep"},{"key":"1862_CR2","doi-asserted-by":"publisher","first-page":"6126534","DOI":"10.1155\/2020\/6126534","volume":"2020","author":"MA Zavalichi","year":"2020","unstructured":"Zavalichi MA, Nistor I, Nedelcu A-E, Zavalichi SD, Georgescu CMA, St\u0103tescu C et al (2020) Extracorporeal membrane oxygenation in cardiogenic shock due to acute myocardial infarction: a systematic review. Biomed Res Int 2020:6126534","journal-title":"Biomed Res Int"},{"key":"1862_CR3","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.ijcard.2016.10.033","volume":"226","author":"A Kataja","year":"2017","unstructured":"Kataja A, Tarvasm\u00e4ki T, Lassus J, Cardoso J, Mebazaa A, K\u00f8ber L et al (2017) The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock\u2014results from the CardShock Study. Int J Cardiol 226:48\u201352","journal-title":"Int J Cardiol"},{"key":"1862_CR4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.resuscitation.2019.11.012","volume":"146","author":"C-H Wang","year":"2020","unstructured":"Wang C-H, Chang W-T, Huang C-H, Tsai M-S, Chou E, Yu P-H et al (2020) Associations between intra-arrest blood glucose level and outcomes of adult in-hospital cardiac arrest: a 10-year retrospective cohort study. Resuscitation 146:103\u2013110","journal-title":"Resuscitation"},{"key":"1862_CR5","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1016\/j.resuscitation.2009.02.011","volume":"80","author":"DG Beiser","year":"2009","unstructured":"Beiser DG, Carr GE, Edelson DP, Peberdy MA, Hoek TLV (2009) Derangements in blood glucose following initial resuscitation from in-hospital cardiac arrest: a report from the national registry of cardiopulmonary resuscitation. Resuscitation 80:624\u2013630","journal-title":"Resuscitation"},{"key":"1862_CR6","doi-asserted-by":"crossref","unstructured":"Abramson TM, Bosson N, Loza-Gomez A, Eckstein M, Gausche-Hill M. Utility of glucose testing and treatment of hypoglycemia in patients with out-of-hospital cardiac arrest. Prehospital Emerg Care 2021:1\u20139.","DOI":"10.1080\/10903127.2020.1869873"},{"key":"1862_CR7","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.jcrc.2017.06.022","volume":"42","author":"I Slottosch","year":"2017","unstructured":"Slottosch I, Liakopoulos O, Kuhn E, Scherner M, Deppe A-C, Sabashnikov A et al (2017) Lactate and lactate clearance as valuable tool to evaluate ECMO therapy in cardiogenic shock. J Crit Care 42:35\u201341","journal-title":"J Crit Care"},{"key":"1862_CR8","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1177\/2048872618789052","volume":"8","author":"T Wengenmayer","year":"2019","unstructured":"Wengenmayer T, Duerschmied D, Graf E, Chiabudini M, Benk C, M\u00fchlschlegel S et al (2019) Development and validation of a prognostic model for survival in patients treated with venoarterial extracorporeal membrane oxygenation: the PREDICT VA-ECMO score. Eur Heart J Acute Cardiovasc Care 8:350\u2013359","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"1862_CR9","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1097\/PCC.0000000000000304","volume":"16","author":"S Lou","year":"2015","unstructured":"Lou S, MacLaren G, Paul E, Best D, Delzoppo C, Butt W (2015) Prevalence of dysglycemia and association with outcomes in pediatric extracorporeal membrane oxygenation. Pediatr Crit Care Med 16:270\u2013275","journal-title":"Pediatr Crit Care Med"},{"key":"1862_CR10","doi-asserted-by":"publisher","first-page":"3385","DOI":"10.1161\/01.CIR.0000147236.85306.15","volume":"110","author":"I Jacobs","year":"2004","unstructured":"Jacobs I, Nadkarni V, Bahr J, Berg RA et al (2004) cardiac arrest and cardiopulmonary resuscitation outcome reports. Circulation 110:3385\u20133397","journal-title":"Circulation"},{"key":"1862_CR11","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1007\/s10049-016-0166-5","volume":"19","author":"A Supady","year":"2016","unstructured":"Supady A, Wengenmayer T, Bode C, Staudacher DL (2016) Extrakorporale CPR (eCPR). Notfall Rettungsmed 19:574\u2013581","journal-title":"Notfall Rettungsmed"},{"key":"1862_CR12","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/s13054-017-1744-8","volume":"21","author":"T Wengenmayer","year":"2017","unstructured":"Wengenmayer T, Rombach S, Ramshorn F, Biever P, Bode C, Duerschmied D et al (2017) Influence of low-flow time on survival after extracorporeal cardiopulmonary resuscitation (eCPR). Crit Care 21:157","journal-title":"Crit Care"},{"key":"1862_CR13","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.jcrc.2016.09.017","volume":"37","author":"DL Staudacher","year":"2017","unstructured":"Staudacher DL, Gold W, Biever PM, Bode C, Wengenmayer T (2017) Early fluid resuscitation and volume therapy in venoarterial extracorporeal membrane oxygenation. J Crit Care 37:130\u2013135","journal-title":"J Crit Care"},{"key":"1862_CR14","doi-asserted-by":"publisher","first-page":"2312","DOI":"10.1007\/s00134-018-5443-y","volume":"44","author":"T Wengenmayer","year":"2018","unstructured":"Wengenmayer T, Schroth F, Biever PM, Duerschmied D, Benk C, Trummer G et al (2018) Albumin fluid resuscitation in patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy is associated with improved survival. Intensive Care Med 44:2312\u20132314","journal-title":"Intensive Care Med"},{"key":"1862_CR15","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1016\/j.amjcard.2013.06.007","volume":"112","author":"JW Deckers","year":"2013","unstructured":"Deckers JW, van Domburg RT, Akkerhuis M, Nauta ST (2013) Relation of admission glucose levels, short- and long-term (20-year) mortality after acute myocardial infarction. Am J Cardiol 112:1306\u20131310","journal-title":"Am J Cardiol"},{"key":"1862_CR16","doi-asserted-by":"publisher","first-page":"e3397","DOI":"10.1136\/bmj.e3397","volume":"344","author":"PM Lepper","year":"2012","unstructured":"Lepper PM, Ott S, N\u00fcesch E, von Eynatten M, Schumann C, Pletz MW et al (2012) Serum glucose levels for predicting death in patients admitted to hospital for community acquired pneumonia: prospective cohort study. BMJ 344:e3397","journal-title":"BMJ"},{"key":"1862_CR17","doi-asserted-by":"publisher","first-page":"R224","DOI":"10.1186\/cc9369","volume":"14","author":"SE Siegelaar","year":"2010","unstructured":"Siegelaar SE, Hermanides J, Oudemans-van Straaten HM, van der Voort PH, Bosman RJ, Zandstra DF et al (2010) Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients: a retrospective cohort study. Crit Care 14:R224","journal-title":"Crit Care"},{"key":"1862_CR18","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/S2213-8587(15)00223-5","volume":"3","author":"D Mesotten","year":"2015","unstructured":"Mesotten D, Preiser J-C, Kosiborod M (2015) Glucose management in critically ill adults and children. Lancet Diabetes Endocrinol 3:723\u2013733","journal-title":"Lancet Diabetes Endocrinol"},{"key":"1862_CR19","volume-title":"Le\u00e7ons sur le diab\u00e8te et la glycogen\u00e8se animale","author":"C Bernard","year":"1877","unstructured":"Bernard C (1877) Le\u00e7ons sur le diab\u00e8te et la glycogen\u00e8se animale. Librairie J.-B. Bailli\u00e8re, Paris"},{"key":"1862_CR20","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1097\/01.CCM.0000194536.89694.06","volume":"34","author":"TM Vriesendorp","year":"2006","unstructured":"Vriesendorp TM, van Santen S, DeVries JH, de Jonge E, Rosendaal FR, Schultz MJ et al (2006) Predisposing factors for hypoglycemia in the intensive care unit. Crit Care Med 34:96\u2013101","journal-title":"Crit Care Med"},{"key":"1862_CR21","doi-asserted-by":"crossref","unstructured":"NICE-SUGAR Study Investigators, Finfer S, Liu B, Chittock DR, Norton R, Myburgh JA, et al (2012) Hypoglycemia and risk of death in critically ill patients. N Engl J Med 367:1108\u201318.","DOI":"10.1056\/NEJMoa1204942"},{"key":"1862_CR22","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.cardfail.2012.03.002","volume":"18","author":"C Ukena","year":"2012","unstructured":"Ukena C, Dobre D, Mahfoud F, Kindermann I, Lamiral Z, Tala S et al (2012) Hypo- and hyperglycemia predict outcome in patients with left ventricular dysfunction after acute myocardial infarction: data from EPHESUS. J Card Fail 18:439\u2013445","journal-title":"J Card Fail"},{"key":"1862_CR23","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1097\/CCM.0000000000000214","volume":"42","author":"K-M Kaukonen","year":"2014","unstructured":"Kaukonen K-M, Bailey M, Egi M, Orford N, Glassford NJ, Marik PE et al (2014) Stress hyperlactatemia modifies the relationship between stress hyperglycemia and outcome: a retrospective observational study*. Crit Care Med 42:1379\u20131385","journal-title":"Crit Care Med"},{"key":"1862_CR24","doi-asserted-by":"publisher","first-page":"3001","DOI":"10.1097\/CCM.0b013e3181b083f7","volume":"37","author":"M Falciglia","year":"2009","unstructured":"Falciglia M, Freyberg RW, Almenoff PL, D\u2019Alessio DA, Render ML (2009) Hyperglycemia-related mortality in critically Ill patients varies with admission diagnosis. Crit Care Med 37:3001\u20133009","journal-title":"Crit Care Med"},{"key":"1862_CR25","doi-asserted-by":"publisher","first-page":"6279","DOI":"10.1038\/s41598-019-42666-0","volume":"9","author":"W-I Liao","year":"2019","unstructured":"Liao W-I, Wang J-C, Lin C-S, Yang C-J, Hsu C-C, Chu S-J et al (2019) Elevated glycemic gap predicts acute respiratory failure and in-hospital mortality in acute heart failure patients with diabetes. Sci Rep 9:6279","journal-title":"Sci Rep"},{"key":"1862_CR26","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1111\/j.1748-1716.1982.tb10595.x","volume":"116","author":"J Ware","year":"1982","unstructured":"Ware J, Ljungqvist O, Norberg KA, Efendic S, Nylander G (1982) Glucose, insulin and osmolality changes in rats sustaining different hemorrhage volumes. Acta Physiol Scand 116:31\u201336","journal-title":"Acta Physiol Scand"},{"key":"1862_CR27","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1056\/NEJMoa070716","volume":"358","author":"FM Brunkhorst","year":"2008","unstructured":"Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N et al (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 358:125\u2013139","journal-title":"N Engl J Med."},{"key":"1862_CR28","doi-asserted-by":"crossref","unstructured":"NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY-S, Blair D, Foster D, et al (2009) Intensive versus conventional glucose control in critically ill patients. N Engl J Med 360:1283\u201397.","DOI":"10.1056\/NEJMoa0810625"},{"key":"1862_CR29","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s00134-013-3189-0","volume":"40","author":"P Kalfon","year":"2014","unstructured":"Kalfon P, Giraudeau B, Ichai C, Guerrini A, Brechot N, Cinotti R et al (2014) Tight computerized versus conventional glucose control in the ICU: a randomized controlled trial. Intensive Care Med 40:171\u2013181","journal-title":"Intensive Care Med"},{"key":"1862_CR30","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1186\/cc12514","volume":"17","author":"PE Marik","year":"2013","unstructured":"Marik PE, Bellomo R (2013) Stress hyperglycemia: an essential survival response! Crit Care 17:305","journal-title":"Crit Care"},{"key":"1862_CR31","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.2337\/db13-0468","volume":"63","author":"E Chow","year":"2014","unstructured":"Chow E, Bernjak A, Williams S, Fawdry RA, Hibbert S, Freeman J et al (2014) Risk of cardiac arrhythmias during hypoglycemia in patients with type 2 diabetes and cardiovascular risk. Diabetes 63:1738\u20131747","journal-title":"Diabetes"},{"key":"1862_CR32","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.3389\/fphys.2018.01669","volume":"9","author":"LA Grisanti","year":"2018","unstructured":"Grisanti LA (2018) Diabetes and arrhythmias: pathophysiology, mechanisms and therapeutic outcomes. Front Physiol 9:1669","journal-title":"Front Physiol"},{"key":"1862_CR33","doi-asserted-by":"publisher","first-page":"3102","DOI":"10.1093\/eurheartj\/eht374","volume":"34","author":"P Ponikowski","year":"2013","unstructured":"Ponikowski P, Jankowska EA (2013) Hypoglycaemia in diabetic patients: highly undesirable by cardiologists. Eur Heart J 34:3102\u20133105","journal-title":"Eur Heart J"},{"key":"1862_CR34","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.ehj.2003.12.014","volume":"25","author":"M Zeller","year":"2004","unstructured":"Zeller M, Cottin Y, Brindisi M-C, Dentan G, Laurent Y, Janin-Manificat L et al (2004) Impaired fasting glucose and cardiogenic shock in patients with acute myocardial infarction. Eur Heart J 25:308\u2013312","journal-title":"Eur Heart J"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-021-01862-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-021-01862-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-021-01862-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T11:05:12Z","timestamp":1630321512000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-021-01862-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,4]]},"references-count":34,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["1862"],"URL":"https:\/\/doi.org\/10.1007\/s00392-021-01862-7","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,4]]},"assertion":[{"value":"25 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"AS reports research grants and lecture fees from CytoSorbents and lecture fees from Abiomed, both outside the submitted work. The other authors declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"This retrospective study was approved by the ethics committee of the Albert Ludwigs University of Freiburg, file number 151\/14. Patient consent to participate was not needed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}