PMID- 33191993
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220211
IS  - 0970-9134 (Print)
IS  - 0973-7723 (Electronic)
IS  - 0970-9134 (Linking)
VI  - 37
IP  - Suppl 2
DP  - 2021 Apr
TI  - The challenges of venoarterial extracorporeal membrane oxygenation for 
      postcardiotomy cardiogenic shock.
PG  - 289-293
LID - 10.1007/s12055-020-01068-y [doi]
AB  - Postcardiotomy cardiogenic shock describes the syndrome of refractory cardiac 
      performance following cardiac surgery. The use of venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) for the management of postcardiotomy cardiogenic 
      shock is controversial, and there are at least three scenarios where it may be 
      necessary: first, pre-emptive postoperative VA-ECMO, where the decision for 
      postoperative mechanical support is made prior to surgery, for example, in the 
      context of poor pre-operative cardiac function; second, early yet unplanned 
      post-cardiopulmonary bypass VA-ECMO following a long duration of cardiopulmonary 
      bypass due to, for example, unexpected surgical complications; third, late rescue 
      VA-ECMO following several attempts at weaning, either immediately following 
      cardiopulmonary bypass or following transfer to the intensive care unit. The use 
      of mechanical circulatory support for postcardiotomy cardiogenic shock is further 
      complicated by the wide range of available devices, the availability of VA-ECMO 
      in different centres, variations in experience and expertise as a function of 
      local VA-ECMO workload, and regional variations in the diagnosis and management 
      of postcardiotomy cardiogenic shock. Furthermore, survival appears to be low for 
      such patients and it is not yet possible to predict who will survive. Many 
      questions remain, however, such as those in relation to practices around patient 
      selection, how best to study long-term outcomes, the ethics and efficacy of ECMO 
      in such patients, and on all aspects of clinical decision-making. This review 
      sets these clinical challenges in the context of the available evidence, 
      including that from our centre.
CI  - (c) Indian Association of Cardiovascular-Thoracic Surgeons 2020.
FAU - Michael, Charlesworth
AU  - Michael C
AUID- ORCID: 0000-0001-7389-4955
AD  - Department of Cardiothoracic Critical Care, Anaesthesia and ECMO, Wythenshawe 
      Hospital, Manchester, UK. GRID: grid.417286.e. ISNI: 0000 0004 0422 2524
FAU - Venkateswaran, Rajamiyer
AU  - Venkateswaran R
AD  - Department of Cardiothoracic Surgery and Transplantation, Wythenshawe Hospital, 
      Manchester, UK. GRID: grid.417286.e. ISNI: 0000 0004 0422 2524
LA  - eng
PT  - Journal Article
DEP - 20201107
PL  - India
TA  - Indian J Thorac Cardiovasc Surg
JT  - Indian journal of thoracic and cardiovascular surgery
JID - 8700105
PMC - PMC7647888
OTO - NOTNLM
OT  - Cardiac surgery
OT  - Cardiogenic shock
OT  - ECMO
OT  - Postcardiotomy
OT  - Venoarterial extracorporeal membrane oxygenation
COIS- Conflict of interestThe authors declare that they have no conflict of interest.
EDAT- 2020/11/17 06:00
MHDA- 2020/11/17 06:01
PMCR- 2022/04/01
CRDT- 2020/11/16 08:42
PHST- 2020/06/22 00:00 [received]
PHST- 2020/09/22 00:00 [revised]
PHST- 2020/09/25 00:00 [accepted]
PHST- 2020/11/17 06:00 [pubmed]
PHST- 2020/11/17 06:01 [medline]
PHST- 2020/11/16 08:42 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 1068 [pii]
AID - 10.1007/s12055-020-01068-y [doi]
PST - ppublish
SO  - Indian J Thorac Cardiovasc Surg. 2021 Apr;37(Suppl 2):289-293. doi: 
      10.1007/s12055-020-01068-y. Epub 2020 Nov 7.