PMID- 33140587 OWN - NLM STAT- MEDLINE DCOM- 20210929 LR - 20210929 IS - 1598-6357 (Electronic) IS - 1011-8934 (Print) IS - 1011-8934 (Linking) VI - 35 IP - 42 DP - 2020 Nov 2 TI - Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation. PG - e346 LID - 10.3346/jkms.2020.35.e346 [doi] LID - e346 AB - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) might be considered a bridge therapy in patients who are expected to have short waiting times for heart transplantation. We investigated the clinical outcomes of patients who underwent VA-ECMO as a bridge to heart transplantation and whether the deployment of an early extubation ECMO strategy is beneficial. METHODS: Between November 2006 and December 2018, we studied 102 patients who received VA-ECMO as a bridge to heart transplantation. We classified these patients into an early extubation ECMO group (n = 24) and a deferred extubation ECMO group (n = 78) based on the length of the intubated period on VA-ECMO ( 48 hours). The primary outcome was in-hospital mortality. RESULTS: The median duration of early extubation VA-ECMO was 10.0 (4.3-17.3) days. The most common cause for patients to be put on ECMO was dilated cardiomyopathy (65.7%) followed by ischemic cardiomyopathy (11.8%). In-hospital mortality rates for the deferred extubation and early extubation groups, respectively, were 24.4% and 8.3% (P = 0.147). During the study period, in the deferred extubation group, 60 (76.9%) underwent transplantation, while 22 (91.7%) underwent transplantation in the early extubation group. Delirium occurred in 83.3% and 33.3% of patients from the deferred extubation and early extubation groups (P < 0.001) and microbiologically confirmed infection was identified in 64.1% and 41.7% of patients from the two groups (P = 0.051), respectively. CONCLUSION: VA-ECMO as a bridge therapy seems to be feasible for deployment in patients with a short waiting time for heart transplantation. Deployment of the early extubation ECMO strategy was associated with reductions in delirium and infection in this population. CI - (c) 2020 The Korean Academy of Medical Sciences. FAU - Youn, Taeho AU - Youn T AUID- ORCID: 0000-0003-4451-0435 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Kim, Darae AU - Kim D AUID- ORCID: 0000-0003-3284-0904 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Park, Taek Kyu AU - Park TK AUID- ORCID: 0000-0003-1440-3583 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Cho, Yang Hyun AU - Cho YH AUID- ORCID: 0000-0003-1685-3641 AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Cho, Su Hyun AU - Cho SH AUID- ORCID: 0000-0003-0648-0941 AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Ji Yeon AU - Choi JY AUID- ORCID: 0000-0002-7847-2193 AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Sung, Kiick AU - Sung K AUID- ORCID: 0000-0003-0768-9587 AD - Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Choi, Jin Oh AU - Choi JO AUID- ORCID: 0000-0002-2441-2267 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Jeon, Eun Seok AU - Jeon ES AUID- ORCID: 0000-0002-9946-5611 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. FAU - Yang, Jeong Hoon AU - Yang JH AUID- ORCID: 0000-0001-8138-1367 AD - Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. AD - Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhysmc@gmail.com. LA - eng PT - Journal Article DEP - 20201102 PL - Korea (South) TA - J Korean Med Sci JT - Journal of Korean medical science JID - 8703518 SB - IM MH - Adult MH - Cardiomyopathy, Dilated/diagnosis/therapy MH - Extracorporeal Membrane Oxygenation/*adverse effects MH - Female MH - *Heart Transplantation MH - Hospital Mortality MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnosis/therapy MH - Retrospective Studies MH - Shock, Cardiogenic/*etiology/mortality MH - Time Factors MH - Treatment Outcome PMC - PMC7606881 OTO - NOTNLM OT - Cardiogenic Shock OT - Early Extubation OT - Extracorporeal Membrane Oxygenation OT - Heart Transplantation COIS- The authors have no potential conflicts of interest to disclose. EDAT- 2020/11/04 06:00 MHDA- 2021/09/30 06:00 PMCR- 2020/11/02 CRDT- 2020/11/03 05:52 PHST- 2020/06/01 00:00 [received] PHST- 2020/08/24 00:00 [accepted] PHST- 2020/11/03 05:52 [entrez] PHST- 2020/11/04 06:00 [pubmed] PHST- 2021/09/30 06:00 [medline] PHST- 2020/11/02 00:00 [pmc-release] AID - 35.e346 [pii] AID - 10.3346/jkms.2020.35.e346 [doi] PST - epublish SO - J Korean Med Sci. 2020 Nov 2;35(42):e346. doi: 10.3346/jkms.2020.35.e346.