PMID- 33250434
OWN - NLM
STAT- MEDLINE
DCOM- 20211025
LR  - 20220531
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 35
IP  - 9
DP  - 2021 Sep
TI  - Duration of Venoarterial Extracorporeal Membrane Oxygenation and Mortality in 
      Postcardiotomy Cardiogenic Shock.
PG  - 2662-2668
LID - S1053-0770(20)31179-4 [pii]
LID - 10.1053/j.jvca.2020.11.003 [doi]
AB  - OBJECTIVE: The optimal duration of venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) in patients affected by postcardiotomy cardiogenic shock 
      (PCS) remains controversial. The present study was conducted to investigate the 
      effect of VA-ECMO duration on hospital outcomes. DESIGN: Retrospective analysis 
      of an international registry. SETTING: Multicenter study including 19 tertiary 
      university hospitals. PARTICIPANTS: Between January 2010 and March 2018, data on 
      PCS patients receiving VA-ECMO were retrieved from the multicenter PC-ECMO 
      registry. INTERVENTIONS: Patients were stratified according to the following 
      different durations of VA-ECMO therapy: </=three days, four-to-seven days, 
      eight-to-ten days, and >ten days. MEASUREMENTS AND MAIN RESULTS: A total of 725 
      patients, with a mean age of 62.9 +/- 12.9 years, were included. The mean duration 
      of VA-ECMO was 7.1 +/- 6.3 days (range 0-39 d), and 39.4% of patients were 
      supported for </=three days, 29.1% for four-seven days, 15.3% for eight-ten days, 
      and finally 20.7% for >ten days. A total of 391 (53.9%) patients were weaned from 
      VA-ECMO successfully; however, 134 (34.3%) of those patients died before 
      discharge. Multivariate logistic regression showed that prolonged duration of 
      VA-ECMO therapy (four-seven days: adjusted rate 53.6%, odds ratio [OR] 0.28, 95% 
      confidence interval [CI] 0.18-0.44; eight-ten days: adjusted rate 61.3%, OR 0.51, 
      95% CI 0.29-0.87; and >ten days: adjusted rate 59.3%, OR 0.49, 95% CI 0.31-0.81) 
      was associated with lower risk of mortality compared with VA-ECMO lasting </=three 
      days (adjusted rate 78.3%). Patients requiring VA-ECMO therapy for eight-ten days 
      (OR 1.96, 95% CI 1.15-3.33) and >10 days (OR 1.85, 95% CI 1.14-3.02) had 
      significantly greater mortality compared with those on VA-ECMO for 4 to 7 days. 
      CONCLUSIONS: PCS patients weaned from VA-ECMO after four-seven days of support 
      had significantly less mortality compared with those with shorter or longer 
      mechanical support.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Mariscalco, Giovanni
AU  - Mariscalco G
AD  - Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, 
      University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. 
      Electronic address: giovannimariscalco@yahoo.it.
FAU - El-Dean, Zein
AU  - El-Dean Z
AD  - Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, 
      University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
FAU - Yusuff, Hakeem
AU  - Yusuff H
AD  - Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, 
      University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
FAU - Fux, Thomas
AU  - Fux T
AD  - Department of Molecular Medicine and Surgery, Department of Cardiac Surgery, 
      Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
FAU - Dell'Aquila, Angelo M
AU  - Dell'Aquila AM
AD  - Department of Cardiothoracic Surgery, Munster University Hospital, Munster, 
      Germany.
FAU - Jonsson, Kristjan
AU  - Jonsson K
AD  - Department of Cardiac Surgery, Sahlgrenska University Hospital, Gothenburg, 
      Sweden.
FAU - Ragnarsson, Sigurdur
AU  - Ragnarsson S
AD  - Department of Cardiothoracic Surgery, University of Lund, Lund, Sweden.
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 - di Perna, Dario
AU  - di Perna D
AD  - Division of Cardiothoracic and Vascular Surgery, Robert Debre University 
      Hospital, Reims, France.
FAU - Gatti, Giuseppe
AU  - Gatti G
AD  - Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
FAU - Juvonen, Tatu
AU  - Juvonen T
AD  - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research 
      Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, 
      University of Oulu, Oulu, Finland.
FAU - Zipfel, Svante
AU  - Zipfel S
AD  - Hamburg University Heart Center, Hamburg, Germany.
FAU - Perrotti, Andrea
AU  - Perrotti A
AD  - Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean 
      Minjoz, Besancon, France.
FAU - Bounader, Karl
AU  - Bounader K
AD  - Division of Cardiothoracic and Vascular Surgery, Pontchaillou University 
      Hospital, Rennes, France.
FAU - Alkhamees, Khalid
AU  - Alkhamees K
AD  - Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia.
FAU - Loforte, Antonio
AU  - Loforte A
AD  - Department of Cardiothoracic, Transplantation and Vascular Surgery, S. Orsola 
      Hospital, University of Bologna, Bologna, Italy.
FAU - Lechiancole, Andrea
AU  - Lechiancole A
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-Limburg, Genk, Belgium.
FAU - De Keyzer, Dieter
AU  - De Keyzer D
AD  - Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - Welp, Henryk
AU  - Welp H
AD  - Department of Cardiothoracic Surgery, Munster University Hospital, Munster, 
      Germany.
FAU - Maselli, Daniele
AU  - Maselli D
AD  - Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy.
FAU - Lichtenberg, Artur
AU  - Lichtenberg A
AD  - Department of Cardiovascular Surgery, Universitatsklinikum Dusseldorf, 
      Dusseldorf, Germany.
FAU - Ruggieri, Vito G
AU  - Ruggieri VG
AD  - Division of Cardiothoracic and Vascular Surgery, Robert Debre University 
      Hospital, Reims, France.
FAU - Biancari, Fausto
AU  - Biancari F
AD  - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research 
      Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, 
      University of Oulu, Oulu, Finland; Department of Surgery, University of Turku, 
      Turku, Finland.
CN  - PC-ECMO Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20201105
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
MH  - Aged
MH  - *Extracorporeal Membrane Oxygenation
MH  - Hospital Mortality
MH  - Humans
MH  - Middle Aged
MH  - Retrospective Studies
MH  - *Shock, Cardiogenic/mortality/therapy
MH  - Tertiary Care Centers
OTO - NOTNLM
OT  - ECMO
OT  - cardiac surgery
OT  - duration
OT  - extracorporeal membrane oxygenation
OT  - survival
EDAT- 2020/12/01 06:00
MHDA- 2021/10/26 06:00
CRDT- 2020/11/30 05:34
PHST- 2020/09/22 00:00 [received]
PHST- 2020/11/01 00:00 [revised]
PHST- 2020/11/02 00:00 [accepted]
PHST- 2020/12/01 06:00 [pubmed]
PHST- 2021/10/26 06:00 [medline]
PHST- 2020/11/30 05:34 [entrez]
AID - S1053-0770(20)31179-4 [pii]
AID - 10.1053/j.jvca.2020.11.003 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2021 Sep;35(9):2662-2668. doi: 
      10.1053/j.jvca.2020.11.003. Epub 2020 Nov 5.