PMID- 31970800
OWN - NLM
STAT- MEDLINE
DCOM- 20210412
LR  - 20210412
IS  - 1525-1594 (Electronic)
IS  - 0160-564X (Linking)
VI  - 44
IP  - 7
DP  - 2020 Jul
TI  - Venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic 
      shock-A six-year service evaluation.
PG  - 709-716
LID - 10.1111/aor.13647 [doi]
AB  - Only a small number of English hospitals provide postcardiotomy venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) and there are doubts about its 
      efficacy and safety. The aim of this service evaluation was to determine local 
      survival rates and report on patient demographics. This was a retrospective 
      service evaluation of prospectively recorded routine clinical data from a 
      tertiary cardiothoracic center in the United Kingdom offering services including 
      cardiac and thoracic surgery, heart and lung transplantation, venovenous 
      extracorporeal membrane oxygenation (VV-ECMO) for respiratory failure, and all 
      types of mechanical circulatory support. In six years, 39 patients were supported 
      with VA-ECMO for refractory postcardiotomy cardiogenic shock (PCCS). We analyzed 
      survival data and looked for associations between survival rates and patient 
      characteristics. The intervention was venoarterial-ECMO in patients with PCCS 
      either following weaning from cardiopulmonary bypass or following a trial of 
      inotropes and intra-aortic balloon counterpulsation on the intensive care unit. 
      30-day, hospital discharge, 1-year and 2-year survivals were 51.3%, 41%, 37.5%, 
      and 38.5%, respectively. The median (IQR [range]) duration of support was 6 (4-9 
      [1-35]) days. Nonsurvival was associated with advanced age, shorter intensive 
      care length of stay, and the requirement for postoperative hemofiltration. 
      Reasonable survival rates can be achieved in selected patients who may have been 
      expected to have a worse mortality without VA-ECMO. We suggest postoperative 
      VA-ECMO should be available to all patients undergoing cardiac surgery be it in 
      their own center or through an established pathway to a specialist center.
CI  - (c) 2020 International Center for Artificial Organs and Transplantation and Wiley 
      Periodicals, Inc.
FAU - Charlesworth, Michael
AU  - Charlesworth M
AUID- ORCID: 0000-0001-7389-4955
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Garcia, Miguel
AU  - Garcia M
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Head, Laura
AU  - Head L
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Barker, Julian M
AU  - Barker JM
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Ashworth, Alan D
AU  - Ashworth AD
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Barnard, James B
AU  - Barnard JB
AD  - Department of Cardiothoracic Surgery and Transplantation, Wythenshawe Hospital, 
      Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Feddy, Lee
AU  - Feddy L
AD  - Department of Cardiothoracic Anaesthesia, Critical Care and ECMO, Wythenshawe 
      Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
FAU - Venkateswaran, Rajamiyer V
AU  - Venkateswaran RV
AD  - Department of Cardiothoracic Surgery and Transplantation, Wythenshawe Hospital, 
      Manchester University NHS Foundation Trust, Manchester, UK.
AD  - Department of Cardiovascular Science, University of Manchester, Manchester, UK.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20200223
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Extracorporeal Membrane Oxygenation/*adverse effects
MH  - Female
MH  - Hemofiltration/statistics & numerical data
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/etiology/mortality/*therapy
MH  - Program Evaluation
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Shock, Cardiogenic/etiology/mortality/*therapy
MH  - Survival Rate
MH  - Tertiary Care Centers/*organization & administration/statistics & numerical data
MH  - Treatment Outcome
OTO - NOTNLM
OT  - VA-ECMO
OT  - cardiac surgery
OT  - cardiogenic shock
OT  - postcardiotomy
EDAT- 2020/01/24 06:00
MHDA- 2021/04/13 06:00
CRDT- 2020/01/24 06:00
PHST- 2019/10/12 00:00 [received]
PHST- 2019/12/03 00:00 [revised]
PHST- 2020/01/14 00:00 [accepted]
PHST- 2020/01/24 06:00 [pubmed]
PHST- 2021/04/13 06:00 [medline]
PHST- 2020/01/24 06:00 [entrez]
AID - 10.1111/aor.13647 [doi]
PST - ppublish
SO  - Artif Organs. 2020 Jul;44(7):709-716. doi: 10.1111/aor.13647. Epub 2020 Feb 23.