Autor: |
Yusuff, Hakeem, Biancari, Fausto, Jónsson, Kristján, Ragnarsson, Sigurdur, Dalén, Magnus, Fux, Thomas, Dell'Aquila, Angelo M., Fiore, Antonio, Perna, Dario Di, Gatti, Giuseppe, Gabrielli, Marco, Juvonen, Tatu, Zipfel, Svante, Bounader, Karl, Perrotti, Andrea, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Pettinari, Matteo, De Keyzer, Dieter |
Zdroj: |
Journal of Cardiothoracic & Vascular Anesthesia; Dec2021, Vol. 35 Issue 12, p3620-3625, 6p |
Abstrakt: |
Data on patients requiring a second run of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in patients affected by postcardiotomy cardiogenic shock (PCS) are very limited. The authors aimed to investigate the effect of a second run of VA-ECMO on PCS patient survival. Retrospective analysis of an international registry. Multicenter study, tertiary university hospitals. Data on adult PCS patients receiving a second run of VA-ECMO. A total of 674 patients with a mean age of 62.9 ± 12.7 years were analyzed, and 21 (3.1%) patients had a second run of VA-ECMO. None of them required more than two VA-ECMO runs. The median duration of VA-ECMO therapy was 135 hours (interquartile range [IQR] 61-226) in patients who did not require a VA-ECMO rerun. In the rerun VA-ECMO group the median overall duration of VA-ECMO therapy was 183 hours (IQR 107-344), and the median duration of the first run was 114 hours (IQR 66-169). Nine (42.9%) of the patients who required a second run of VA-ECMO died during VA-ECMO therapy, whereas five (23.8%) survived to hospital discharge. No differences between patients treated with single or second VA-ECMO runs were observed in terms of hospital mortality and late survival. In patients requiring a second VA-ECMO run, the actuarial survival estimates at three and 12 months after VA-ECMO weaning were 23.8% ± 9.3% and 19.6% ± 6.4%, respectively. Repeat VA-ECMO therapy is a valid treatment strategy for PCS patients. Early and late survivals are similar between patients who have undergone a single or second run of VA-ECMO. [ABSTRACT FROM AUTHOR] |
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