PMID- 31864699
OWN - NLM
STAT- MEDLINE
DCOM- 20201123
LR  - 20201123
IS  - 1097-685X (Electronic)
IS  - 0022-5223 (Linking)
VI  - 160
IP  - 5
DP  - 2020 Nov
TI  - Peripheral versus central extracorporeal membrane oxygenation for postcardiotomy 
      shock: Multicenter registry, systematic review, and meta-analysis.
PG  - 1207-1216.e44
LID - S0022-5223(19)32376-1 [pii]
LID - 10.1016/j.jtcvs.2019.10.078 [doi]
AB  - BACKGROUND: We hypothesized that cannulation strategy in venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) could play a crucial role in the 
      perioperative survival of patients affected by postcardiotomy shock. METHODS: 
      Between January 2010 and March 2018, 781 adult patients receiving VA-ECMO for 
      postcardiotomy shock at 19 cardiac surgical centers were retrieved from the 
      Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation study registry. 
      A parallel systematic review and meta-analysis (PubMed/MEDLINE, Embase, and 
      Cochrane Library) through December 2018 was also accomplished. RESULTS: Central 
      and peripheral VA-ECMO cannulation were performed in 245 (31.4%) and 536 (68.6%) 
      patients, respectively. Main indications for the institution VA-ECMO were failure 
      to wean from cardiopulmonary bypass (38%) and heart failure following 
      cardiopulmonary bypass weaning (48%). The doubly robust analysis after inverse 
      probability treatment weighting by propensity score demonstrated that central 
      VA-ECMO was associated with greater hospital mortality (odds ratio 1.54; 95% 
      confidence interval, 1.09-2.18), reoperation for bleeding/tamponade (odds ratio, 
      1.96; 95% confidence interval, 1.37-2.81), and transfusion of more than 9 RBC 
      units (odds ratio, 2.42; 95% confidence interval, 1.59-3.67). The systematic 
      review provided a total of 2491 individuals with postcardiotomy shock treated 
      with VA-ECMO. Pooled prevalence of in-hospital/30-day mortality in overall 
      patient population was 66.6% (95% confidence interval, 64.7-68.4%), and pooled 
      unadjusted risk ratio analysis confirmed that patients undergoing peripheral 
      VA-ECMO had a lower in-hospital/30-day mortality than patients undergoing central 
      cannulation (risk ratio, 0.92; 95% confidence interval, 0.87-0.98). Adjustments 
      for important confounders did not alter our results. CONCLUSIONS: In patients 
      with postcardiotomy shock treated with VA-ECMO, central cannulation was 
      associated with greater in-hospital mortality than peripheral cannulation.
CI  - Copyright (c) 2019 The American Association for Thoracic Surgery. Published by 
      Elsevier Inc. All rights reserved.
FAU - Mariscalco, Giovanni
AU  - Mariscalco G
AD  - Department of Cardiac Surgery, Glenfield Hospital, University Hospitals of 
      Leicester, Leicester, United Kingdom. Electronic address: 
      giovannimariscalco@yahoo.it.
FAU - Salsano, Antonio
AU  - Salsano A
AD  - Division of Cardiac Surgery, Department of Integrated Surgical and Diagnostic 
      Sciences (DISC), University of Genoa, Genoa, Italy.
FAU - Fiore, Antonio
AU  - Fiore A
AD  - Department of Cardiothoracic Surgery, Henri Mondor University Hospital, AP-HP, 
      Paris-Est University, Creteil, France.
FAU - Dalen, Magnus
AU  - Dalen M
AD  - Department of Molecular Medicine and Surgery, Department of Cardiac Surgery, 
      Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
FAU - Ruggieri, Vito G
AU  - Ruggieri VG
AD  - Division of Cardiothoracic and Vascular Surgery, Robert Debre University 
      Hospital, Reims, France.
FAU - Saeed, Diyar
AU  - Saeed D
AD  - Cardiovascular Surgery, University Hospital of Dusseldorf, Dusseldorf, Germany.
FAU - Jonsson, Kristjan
AU  - Jonsson K
AD  - Department of Cardiac Surgery, Sahlgrenska University Hospital, Gothenburg, 
      Sweden.
FAU - Gatti, Giuseppe
AU  - Gatti G
AD  - Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
FAU - Zipfel, Svante
AU  - Zipfel S
AD  - Hamburg University Heart Center, Hamburg, Germany.
FAU - Dell'Aquila, Angelo M
AU  - Dell'Aquila AM
AD  - Department of Cardiothoracic Surgery, Munster University Hospital, Munster, 
      Germany.
FAU - Perrotti, Andrea
AU  - Perrotti A
AD  - Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean 
      Minjoz, Besancon, France.
FAU - Loforte, Antonio
AU  - Loforte A
AD  - Department of Cardiothoracic, Transplantation and Vascular Surgery, S. Orsola 
      Hospital, University of Bologna, Bologna, Italy.
FAU - Livi, Ugolino
AU  - Livi U
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Pol, Marek
AU  - Pol M
AD  - Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
FAU - Spadaccio, Cristiano
AU  - Spadaccio C
AD  - Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, 
      United Kingdom.
FAU - Pettinari, Matteo
AU  - Pettinari M
AD  - Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburgl, Genk, Belgium.
FAU - Ragnarsson, Sigurdur
AU  - Ragnarsson S
AD  - Department of Cardiothoracic Surgery, University of Lund, Lund, Sweden.
FAU - Alkhamees, Khalid
AU  - Alkhamees K
AD  - Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia.
FAU - El-Dean, Zein
AU  - El-Dean Z
AD  - Department of Cardiac Surgery, Glenfield Hospital, University Hospitals of 
      Leicester, Leicester, United Kingdom.
FAU - Bounader, Karl
AU  - Bounader K
AD  - Division of Cardiothoracic and Vascular Surgery, Pontchaillou University 
      Hospital, Rennes, France.
FAU - Biancari, Fausto
AU  - Biancari F
AD  - Heart Center, Turku University Hospital and University of Turku, Turku, Finland; 
      Department of Surgery, University of Oulu, Oulu, Finland.
CN  - PC-ECMO group
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20191031
PL  - United States
TA  - J Thorac Cardiovasc Surg
JT  - The Journal of thoracic and cardiovascular surgery
JID - 0376343
SB  - IM
CIN - J Thorac Cardiovasc Surg. 2020 Nov;160(5):1218-1219. PMID: 31926726
CIN - J Thorac Cardiovasc Surg. 2020 Nov;160(5):1220-1221. PMID: 31928828
CIN - J Thorac Cardiovasc Surg. 2020 Nov;160(5):1217-1218. PMID: 31987618
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - *Extracorporeal Membrane Oxygenation/adverse effects/methods/mortality
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*surgery
MH  - Shock/*surgery
OTO - NOTNLM
OT  - ECMO
OT  - cardiac surgery
OT  - extracorporeal membrane oxygenation
OT  - postcardiotomy
FIR - Dashey, Susan
IR  - Dashey S
FIR - Yusuff, Hakeem
IR  - Yusuff H
FIR - Porter, Richard
IR  - Porter R
FIR - Sampson, Caroline
IR  - Sampson C
FIR - Harvey, Chris
IR  - Harvey C
FIR - Settembre, Nicla
IR  - Settembre N
FIR - Fux, Thomas
IR  - Fux T
FIR - Amr, Gilles
IR  - Amr G
FIR - Lichtenberg, Artur
IR  - Lichtenberg A
FIR - Jeppsson, Anders
IR  - Jeppsson A
FIR - Gabrielli, Marco
IR  - Gabrielli M
FIR - Reichart, Daniel
IR  - Reichart D
FIR - Welp, Henryk
IR  - Welp H
FIR - Chocron, Sidney
IR  - Chocron S
FIR - Fiorentino, Mariafrancesca
IR  - Fiorentino M
FIR - Lechiancole, Andrea
IR  - Lechiancole A
FIR - Netuka, Ivan
IR  - Netuka I
FIR - De Keyzer, Dieter
IR  - De Keyzer D
FIR - Strauven, Maarten
IR  - Strauven M
FIR - Palve, Kristiina
IR  - Palve K
EDAT- 2019/12/23 06:00
MHDA- 2020/11/24 06:00
CRDT- 2019/12/23 06:00
PHST- 2019/05/08 00:00 [received]
PHST- 2019/10/04 00:00 [revised]
PHST- 2019/10/04 00:00 [accepted]
PHST- 2019/12/23 06:00 [pubmed]
PHST- 2020/11/24 06:00 [medline]
PHST- 2019/12/23 06:00 [entrez]
AID - S0022-5223(19)32376-1 [pii]
AID - 10.1016/j.jtcvs.2019.10.078 [doi]
PST - ppublish
SO  - J Thorac Cardiovasc Surg. 2020 Nov;160(5):1207-1216.e44. doi: 
      10.1016/j.jtcvs.2019.10.078. Epub 2019 Oct 31.