PMID- 34434969
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210827
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 8
DP  - 2021
TI  - Postcardiotomy Veno-Arterial Extracorporeal Membrane Oxygenation: Does the 
      Cannulation Technique Influence the Outcome?
PG  - 658412
LID - 10.3389/fcvm.2021.658412 [doi]
LID - 658412
AB  - Objectives: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may be 
      cannulated using either central (cannulation of aorta) or peripheral (cannulation 
      of femoral or axillary artery) access. The ideal cannulation approach for 
      postcardiotomy cardiogenic shock (PCS) is still unknown. The aim of this study is 
      to compare the outcome of patients with PCS who were supported with central vs. 
      peripheral cannulation. Methods: This is a single-center retrospective data 
      analysis including all VA-ECMO implantations for PCS from January 2011 to 
      December 2017. The central and peripheral approaches were compared in terms of 
      patient characteristics, intensive care unit (ICU) stay, hospitalization length, 
      adverse event rates, and overall survival. Results: Eighty-six patients met the 
      inclusion criteria. Twenty-eight patients (33%) were cannulated using the central 
      approach, and 58 patients (67%) were cannulated using the peripheral approach. 
      Forty-three patients (50%) received VA-ECMO in the operating room and 43 patients 
      (50%) received VA-ECMO in the ICU. Central VA-ECMO group had higher EuroSCORE II 
      (p = 0.007), longer cross-clamp time (p = 0.054), higher rate of open chest after 
      the procedure (p < 0.001), and higher mortality rate (p = 0.02). After propensity 
      score matching, 20 patients in each group were reanalyzed. In the matched groups, 
      no statistically significant differences were observed in the baseline 
      characteristics between the two groups except for a higher rate of open chests in 
      the central ECMO group (p = 0.02). However, no significant differences were 
      observed in the outcome and complications between the groups. Conclusions: This 
      study showed that in postcardiotomy patients requiring VA-ECMO support, similar 
      complication rates and outcome were observed regardless of the cannulation 
      strategy.
CI  - Copyright (c) 2021 Kalampokas, Sipahi, Aubin, Akhyari, Petrov, Albert, Westenfeld, 
      Lichtenberg and Saeed.
FAU - Kalampokas, Nikolaos
AU  - Kalampokas N
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Sipahi, Nihat Firat
AU  - Sipahi NF
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Aubin, Hug
AU  - Aubin H
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Akhyari, Payam
AU  - Akhyari P
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Petrov, Georgi
AU  - Petrov G
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Albert, Alexander
AU  - Albert A
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Westenfeld, Ralf
AU  - Westenfeld R
AD  - Department of Cardiology, Pulmonology, and Vascular Medicine, University Hospital 
      of Dusseldorf, Dusseldorf, Germany.
FAU - Lichtenberg, Artur
AU  - Lichtenberg A
AD  - Department of Cardiovascular Surgery, University Hospital of Dusseldorf, 
      Dusseldorf, Germany.
FAU - Saeed, Diyar
AU  - Saeed D
AD  - University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20210809
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC8382236
OTO - NOTNLM
OT  - ECMO
OT  - cannulation
OT  - cardiogenic shock
OT  - low cardiac output
OT  - postcardiotomy
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/08/27 06:00
MHDA- 2021/08/27 06:01
PMCR- 2021/01/01
CRDT- 2021/08/26 06:17
PHST- 2021/01/25 00:00 [received]
PHST- 2021/06/23 00:00 [accepted]
PHST- 2021/08/26 06:17 [entrez]
PHST- 2021/08/27 06:00 [pubmed]
PHST- 2021/08/27 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2021.658412 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2021 Aug 9;8:658412. doi: 10.3389/fcvm.2021.658412. 
      eCollection 2021.