Bunge, Jeroen J. H. and Mariani, Silvia and Meuwese, Christiaan and van Bussel, Bas C. T. and Di Mauro, Michele and Wiedeman, Dominik and Saeed, Diyar and Pozzi, Matteo and Loforte, Antonio and Boeken, Udo and Samalavicius, Robertas and Bounader, Karl and Hou, Xiaotong and Buscher, Hergen and Salazar, Leonardo and Meyns, Bart and Herr, Daniel 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 J. R. and Gommers, Diederik and Dos Reis Miranda, Dinis and Lorusso, Roberto (2024) Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study. CRITICAL CARE MEDICINE, 52 (10). e490-e502. ISSN 0090-3493, 1530-0293
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVES: Most post-cardiotomy (PC) extracorporeal membrane oxygenation (ECMO) runs last less than 7 days. Studies on the outcomes of longer runs have provided conflicting results. This study investigates patient characteristics and short- and long-term outcomes in relation to PC ECMO duration, with a focus on prolonged (> 7 d) ECMO. DESIGN: Retrospective observational cohort study. SETTING: Thirty-four centers from 16 countries between January 2000 and December 2020. PATIENTS: Adults requiring post PC ECMO between 2000 and 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Characteristics, in-hospital, and post-discharge outcomes were compared among patients categorized by ECMO duration. Survivors and nonsurvivors were compared in the subgroup of patients with ECMO duration greater than 7 days. The primary outcome was in-hospital mortality. Two thousand twenty-one patients were included who required PC ECMO for 0-3 days (n = 649 [32.1%]), 4-7 days (n = 776 [38.3%]), 8-10 days (n = 263 [13.0%]), and greater than 10 days (n = 333 [16.5%]). There were no major differences in the investigated preoperative and procedural characteristics among ECMO duration groups. However, the longer ECMO duration category was associated with multiple complications including bleeding, acute kidney injury, arrhythmias, and sepsis. Hospital mortality followed a U-shape curve, with lowest mortality in patients with ECMO duration of 4-7 days (n = 394, 50.8%) and highest in patients with greater than 10 days ECMO support (n = 242, 72.7%). There was no significant difference in post-discharge survival between ECMO duration groups. In patients with ECMO duration greater than 7 days, age, comorbidities, valvular diseases, and complex procedures were associated with nonsurvival. CONCLUSIONS: Nearly 30% of PC ECMO patients were supported for greater than 7 days. In-hospital mortality increased after 7 days of support, especially in patients undergoing valvular and complex surgery, or who had complications, although the long-term post-discharge prognosis was comparable to PC ECMO patients with shorter support duration.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIOGENIC-SHOCK; MORTALITY; acute heart failure; cardiac surgery; extracorporeal membrane oxygenation; mechanical circulatory support; post-cardiotomy cardiogenic shock |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Jul 2025 09:29 |
| Last Modified: | 24 Jul 2025 09:29 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65726 |
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