PMID- 34627305
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1749-8090 (Electronic)
IS  - 1749-8090 (Linking)
VI  - 16
IP  - 1
DP  - 2021 Oct 9
TI  - Short-term and intermediate outcomes of cardiogenic shock and cardiac arrest 
      patients supported by venoarterial extracorporeal membrane oxygenation.
PG  - 290
LID - 10.1186/s13019-021-01674-w [doi]
LID - 290
AB  - BACKGROUND: Cardiogenic shock and cardiac arrest are life-threatening emergencies 
      with high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA 
      ECMO) and extracorporeal cardiopulmonary resuscitation (e-CPR) provide viable 
      options for life sustaining measures when medical therapy fails. The purpose of 
      this study is to determine the utilization and outcomes of VA ECMO and eCPR in 
      patients that require emergent cardiac support at a single academic center. 
      METHODS: A retrospective chart review of prospectively collected data was 
      performed at an academic institution from January 1st, 2018 to June 30th, 2020. 
      All consecutive patients who required VA ECMO were evaluated based on whether 
      they underwent traditional VA ECMO or eCPR. The study variables include 
      demographic data, duration on ECMO, length of stay, complications, and survival 
      to discharge. RESULTS: A total of 90 patients were placed on VA ECMO for cardiac 
      support with 44.4% (40) of these patients undergoing eCPR secondary to cardiac 
      arrest and emergent placement on ECMO. A majority of the patients were male 
      (n = 64, 71.1%) and the mean age was 58.8 +/- 15.8 years. 44.4% of patients were 
      transferred from outside hospitals for a higher level of care and 37.8% of 
      patients required another primary therapy such as an Impella or IABP. The most 
      common complication experienced by patients was bleeding (n = 41, 45.6%), which 
      occurred less often in eCPR (n = 29, 58% vs. n = 12, 30%). Other complications 
      included infections (n = 11, 12.2%), limb ischemia (n = 13, 14.4%), acute kidney 
      injury (n = 17, 18.9%), and cerebral vascular accident (n = 4, 4.4%). The length 
      of stay was longer for patients on VA ECMO (32.1 +/- 40.7 days vs. 
      17.7 +/- 18.2 days). Mean time on ECMO was 8.1 +/- 8.3 days. Survival to discharge 
      was higher in VA ECMO patients (n = 23, 46% vs. n = 8, 20%). CONCLUSION: VA ECMO 
      provided an effective rescue therapy in patients in acute cardiogenic shock with 
      a survival greater than the expected ELSO guidelines of 40%. While the survival 
      of eCPR was lower than expected, this may reflect the severity of patient's 
      condition and emphasizes the importance of careful patient selection and 
      planning.
CI  - (c) 2021. The Author(s).
FAU - Vakil, Deep
AU  - Vakil D
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Soto, Cassandra
AU  - Soto C
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - D'Costa, Zoee
AU  - D'Costa Z
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Volk, Lindsay
AU  - Volk L
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Kandasamy, Sivaveera
AU  - Kandasamy S
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Iyer, Deepa
AU  - Iyer D
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Ikegami, Hirohisa
AU  - Ikegami H
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Russo, Mark J
AU  - Russo MJ
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Lee, Leonard Y
AU  - Lee LY
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA.
FAU - Lemaire, Anthony
AU  - Lemaire A
AUID- ORCID: 0000-0002-8936-9853
AD  - Division of Cardiothoracic Surgery, Department of Surgery, RUTGERS-Robert Wood 
      Johnson Medical School, 125 Paterson Street, New Brunswick, NJ, 08903, USA. 
      Anthony.lemaire@rwjms.rutgers.edu.
LA  - eng
PT  - Journal Article
DEP - 20211009
PL  - England
TA  - J Cardiothorac Surg
JT  - Journal of cardiothoracic surgery
JID - 101265113
SB  - IM
MH  - *Cardiopulmonary Resuscitation
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - *Heart Arrest/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/therapy
PMC - PMC8502086
OTO - NOTNLM
OT  - Cardiac arrest
OT  - Cardiogenic shock
OT  - Veno-arterial extracorporeal membrane oxygenation
COIS- The authors declare that they have no competing interests.
EDAT- 2021/10/11 06:00
MHDA- 2021/10/16 06:00
PMCR- 2021/10/09
CRDT- 2021/10/10 20:32
PHST- 2021/06/29 00:00 [received]
PHST- 2021/09/27 00:00 [accepted]
PHST- 2021/10/10 20:32 [entrez]
PHST- 2021/10/11 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/10/09 00:00 [pmc-release]
AID - 10.1186/s13019-021-01674-w [pii]
AID - 1674 [pii]
AID - 10.1186/s13019-021-01674-w [doi]
PST - epublish
SO  - J Cardiothorac Surg. 2021 Oct 9;16(1):290. doi: 10.1186/s13019-021-01674-w.