Bari, Gabor and Mariani, Silvia and van Bussel, Bas C. T. and Ravaux, Justine and Di Mauro, Michele and Schaefer, Anne and Khalil, Jawad and Pozzi, Matteo and Botta, Luca and Pacini, Davide and Boeken, Udo and Samalavicius, Robertas and Bounader, Karl and Hou, Xiaotong and Bunge, Jeroen J. H. and Buscher, Hergen and Salazar, Leonardo and Meyns, Bart and Mazeffi, Michael and Matteucci, Sacha and Sponga, Sandro and MacLaren, Graeme and Russo, Claudio and Formica, Francesco and Sakiyalak, Pranya and Fiore, Antonio and Camboni, Daniele and Raffa, Giuseppe Maria and Diaz, Rodrigo and Wang, I-wen and Jung, Jae-Seung and Belohlavek, Jan and Pellegrino, Vin and Bianchi, Giacomo and Pettinari, Matteo and Barbone, Alessandro and Garcia, Jose P. and Shekar, Kiran and Whitman, Glenn and Lorusso, Roberto (2024) Post-cardiotomy extracorporeal life support: A cohort of cannulation in the general ward. ARTIFICIAL ORGANS, 48 (11). pp. 1355-1365. ISSN 0160-564X, 1525-1594
Full text not available from this repository. (Request a copy)Abstract
ObjectivesPost-cardiotomy extracorporeal life support (ECLS) cannulation might occur in a general post-operative ward due to emergent conditions. Its characteristics have been poorly reported and investigated This study investigates the characteristics and outcomes of adult patients receiving ECLS cannulation in a general post-operative cardiac ward.MethodsThe Post-cardiotomy Extracorporeal Life Support (PELS) is a retrospective (2000-2020), multicenter (34 centers), observational study including adult patients who required ECLS for post-cardiotomy shock. This PELS sub-analysis analyzed patients<acute accent> characteristics, in-hospital outcomes, and long-term survival in patients cannulated for veno-arterial ECLS in the general ward, and further compared in-hospital survivors and non-survivors.ResultsThe PELS study included 2058 patients of whom 39 (1.9%) were cannulated in the general ward. Most patients underwent isolated coronary bypass grafting (CABG, n = 15, 38.5%) or isolated non-CABG operations (n = 20, 51.3%). The main indications to initiate ECLS included cardiac arrest (n = 17, 44.7%) and cardiogenic shock (n = 14, 35.9%). ECLS cannulation occurred after a median time of 4 (2-7) days post-operatively. Most patients' courses were complicated by acute kidney injury (n = 23, 59%), arrhythmias (n = 19, 48.7%), and postoperative bleeding (n = 20, 51.3%). In-hospital mortality was 84.6% (n = 33) with persistent heart failure (n = 11, 28.2%) as the most common cause of death. No peculiar differences were observed between in-hospital survivors and nonsurvivors.ConclusionsThis study demonstrates that ECLS cannulation due to post-cardiotomy emergent adverse events in the general ward is rare, mainly occurring in preoperative low-risk patients and after a postoperative cardiac arrest. High complication rates and low in-hospital survival require further investigations to identify patients at risk for such a complication, optimize resources, enhance intervention, and improve outcomes. 2% of post-cardiotomy ECLS happens in the ward. Mortality is 85% mainly to cardiac arrest, despite low pre-surgical risk Initiation of post-cardiotomy ECLS in the general ward has a poor prognosis. Specific strategies to improve outcome are requiredimage
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIAC-ARREST; RESUSCITATION; GUIDELINE; CONSENSUS; cardiac arrest; cardiac surgery; complications; extracorporeal life support; shock; ward |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Aug 2025 05:18 |
| Last Modified: | 06 Aug 2025 05:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65707 |
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