How Long Should Patients Be Treated With Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation? Individual Patient Data Pooled Analysis

被引：0

作者：

Biancari, Fausto ^{[1
]}

Makikallio, Timo ^{[2
]}

L'Acqua, Camilla ^{[3
,4
]}

Ruggieri, Vito G. ^{[5
]}

Cho, Sung-Min ^{[6
,7
,8
,9
,10
,11
,12
,13
,14
]}

Dalen, Magnus ^{[15
]}

Welp, Henryk ^{[16
]}

Jonsson, Kristjan ^{[17
]}

Ragnarsson, Sigurdur ^{[18
]}

Perez, Francisco J. Hernandez ^{[19
]}

Gatti, Giuseppe ^{[20
]}

Alkhamees, Khalid ^{[21
]}

Loforte, Antonio ^{[22
]}

Lechiancole, Andrea ^{[23
]}

D'Errigo, Paola ^{[24
]}

Rosato, Stefano ^{[24
]}

Spadaccio, Cristiano ^{[25
]}

Pettinari, Matteo ^{[26
]}

Fiore, Antonio ^{[27
]}

Mariscalco, Giovanni ^{[28
]}

Perrotti, Andrea ^{[29
]}

Arafat, Amr A. ^{[30
,31
]}

Albabtain, Monirah A. ^{[32
]}

Albarak, Mohammed M. ^{[33
]}

Laimoud, Mohamed ^{[34
,35
]}

Djordjevic, Ilija ^{[36
]}

Samalavicius, Robertas ^{[37
,38
]}

Alonso-Fernandez-Gatta, Marta ^{[39
,40
]}

Wilhelm, Markus J. ^{[41
,42
]}

Kaserer, Alexander ^{[42
,43
]}

Bonalumi, Giorgia ^{[1
]}

Juvonen, Tatu ^{[44
,45
]}

Polvani, Gianluca ^{[1
,46
]}

机构：

[1] Ctr Cardiol Monzino IRCCS, Dept Cardiac Surg, Milan, Italy

[2] Univ Helsinki, South Karel Cent Hosp, Dept Med, Lappeenranta, Finland

[3] Ctr Cardiol Monzino, Anesthesia & Intens Care Unit, Milan, Italy

[4] Fdn IRCCS Ist Nazl Tumori, Anesthesia & Intens Care Unit, Milan, Italy

[5] Robert Debre Univ Hosp, Div Cardiothorac & Vasc Surg, Reims, France

[6] Johns Hopkins Univ, Sch Med, Div Neurosci, Dept Neurol, Baltimore, MD USA

[7] Johns Hopkins Univ, Sch Med, Dept Neurol, Div Crit Care, Baltimore, MD USA

[8] Johns Hopkins Univ, Sch Med, Dept Neurol, Div Cardiac Surg, Baltimore, MD USA

[9] Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Div Neurosci, Baltimore, MD USA

[10] Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Div Crit Care, Baltimore, MD USA

[11] Johns Hopkins Univ, Sch Med, Dept Anesthesiol, Div Cardiac Surg, Baltimore, MD USA

[12] Johns Hopkins Univ, Sch Med, Dept Crit Care Med, Div Neurosci, Baltimore, MD USA

[13] Johns Hopkins Univ, Sch Med, Dept Crit Care Med, Div Crit Care, Baltimore, MD USA

[14] Johns Hopkins Univ, Sch Med, Dept Crit Care Med, Div Cardiac Surg, Baltimore, MD USA

[15] Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Dept Cardiac Surg, Stockholm, Sweden

[16] Munster Univ Hosp, Dept Cardiothorac Surg, Munster, Germany

[17] Sahlgrens Univ Hosp, Dept Cardiac Surg, Gothenburg, Sweden

[18] Lund Univ, Dept Cardiothorac Surg, Lund, Sweden

[19] Puerta de Hierro Univ Hosp, Dept Cardiol, Madrid, Spain

[20] Univ Hosp Trieste, Cardiothorac & Vasc Dept, Div Cardiac Surg, Trieste, Italy

[21] Prince Sultan Cardiac Ctr, Al Hasa, Saudi Arabia

[22] Univ Turin, Dept Surg Sci, Turin, Italy

[23] Univ Hosp Udine, Cardiothorac Dept, Udine, Italy

[24] Italian Natl Inst, Ctr Global Hlth, Rome, Italy

[25] Univ Cincinnati, Med Ctr, Dept Cardiac Surg, Cincinnati, OH USA

[26] Clin Univ St Luc, Cardiovasc Dept, Cardiac Surg Unit, Brussels, Belgium

[27] Hop Univ Henri Mondor, Dept Cardiac Surg, Creteil, France

[28] Univ Hosp Leicester, Glenfield Hosp, Dept Intens Care Med & Cardiac Surg, Leicester, England

[29] Univ Hosp Jean Minjoz, Dept Thorac & Cardiovasc Surg, Besancon, France

[30] Prince Sultan Cardiac Ctr, Adult Cardiac Surg, Riyadh, Saudi Arabia

[31] Tanta Univ, Cardiothorac Surg Dept, Tanta, Egypt

[32] Prince Sultan Cardiac Ctr, Cardiol Clin Pharm, Riyadh, Saudi Arabia

[33] Prince Sultan Cardiac Ctr, Intens Care Dept, Riyadh, Saudi Arabia

[34] King Faisal Specialist Hosp & Res Ctr, Cardiac Surg Intens Care Dept, Riyadh, Saudi Arabia

[35] Cairo Univ, Crit Care Med Dept, Cairo, Egypt

[36] Univ Hosp Cologne, Dept Cardiothorac Surg, Cologne, Germany

[37] Vilnius Univ Hosp Santaros Klin, Dept Anesthesia 2, Vilnius, Lithuania

[38] Vilnius Univ, Med Fac, Clin Emergency Med, Vilnius, Lithuania

[39] Univ Hosp Salamanca, Cardiol Dept, Inst Invest Biomed Salamanca, Salamanca, Spain

[40] CIBER CV Inst Salud Carlos III, Madrid, Spain

[41] Univ Zurich, Univ Heart Ctr, Clin Cardiac Surg, Zurich, Switzerland

[42] Univ Hosp Zurich, Zurich, Switzerland

[43] Univ Zurich, Inst Anesthesiol, Zurich, Switzerland

[44] Univ Oulu, Res Unit Surg Anesthesiol & Intens Care, Oulu, Finland

[45] Helsinki Univ Hosp, Heart & Lung Ctr, Dept Cardiac Surg, Helsinki, Finland

[46] Univ Milan, Dept Biomed Surg & Dent Sci, Milan, Italy

来源：

CRITICAL CARE MEDICINE | 2025年 / 53卷 / 04期

关键词：

cardiac surgery; extracorporeal life support; extracorporeal membrane oxygenation; postcardiotomy; risk factors;

D O I：

10.1097/CCM.0000000000006618

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

OBJECTIVES:To investigate the optimal duration of venoarterial extracorporeal membrane oxygenation (ECMO) for cardiogenic shock refractory to medical therapies after cardiac surgery and whether its prolonged use is justified.DATA SOURCES:Previously published articles on postcardiotomy venoarterial ECMO.STUDY SELECTION:Articles reporting on the early outcome after postcardiotomy venoarterial ECMO in adult patients were identified through a systematic review of the literature.DATA EXTRACTION:Data on prespecified patients' characteristics, operative variables, and outcomes were provided by the authors of previous studies on this topic.DATA SYNTHESIS:Individual data of 1267 patients treated at 25 hospitals from ten studies were included in this meta-analysis. In-hospital mortality rates were lowest among patients treated 3-6 days with venoarterial ECMO. Multilevel mixed-effects logistic regression considering the cluster effect of the participating hospitals adjusted for individual patient's risk profile and operative variables showed that the risk in-hospital mortality did not significantly increase in patients treated more than 6 days up to 20 days.CONCLUSIONS:The present study demonstrated that prolonged venoarterial ECMO support after adult cardiac surgery may be justified. However, the analysis was limited by the knowledge of only those circumstances known at the start of ECMO.

引用

页码：e908 / e915

页数：8

共 49 条

[31] Clinical Outcomes of Adult Patients Who Receive Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock: A Systematic Review and Meta-Analysis [J].

Wang, Liangshan ;

Wang, Hong ;

Hou, Xiaotong .

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2018, 32 (05) :2087-2093

[32] Assessment of Electrical Impedance Tomography to Set Optimal Positive End-Expiratory Pressure for Venoarterial Extracorporeal Membrane Oxygenation-Treated Patients* [J].

Soule, Christelle ;

Crognier, Laure ;

Puel, Floriane ;

Ruiz, Stephanie ;

Seguin, Thierry ;

Fourcade, Olivier ;

Georges, Bernard ;

Conil, Jean-Marie ;

Minville, Vincent ;

Vardon-Bounes, Fanny .

CRITICAL CARE MEDICINE, 2021, 49 (06) :923-933

[33] Impact of renal complications on outcome in adult patients with acute fulminant myocarditis receiving venoarterial extracorporeal membrane oxygenation: an analysis of nationwide CSECLS database in China [J].

Tong Hao ;

Lei Chen ;

Changde Wu ;

Jianfeng Xie ;

Chenglong Li ;

Haixiu Xie ;

Zhongtao Du ;

Ling Liu ;

Yi Yang ;

Songqiao Liu ;

Xiaotong Hou ;

Haibo Qiu .

Annals of Intensive Care, 13

[34] Impact of renal complications on outcome in adult patients with acute fulminant myocarditis receiving venoarterial extracorporeal membrane oxygenation: an analysis of nationwide CSECLS database in China [J].

Hao, Tong ;

Chen, Lei ;

Wu, Changde ;

Xie, Jianfeng ;

Li, Chenglong ;

Xie, Haixiu ;

Du, Zhongtao ;

Liu, Ling ;

Yang, Yi ;

Liu, Songqiao ;

Hou, Xiaotong ;

Qiu, Haibo .

ANNALS OF INTENSIVE CARE, 2023, 13 (01)

[35] Insomnia disorder and long-term mortality in adult patients treated with extracorporeal membrane oxygenation in South Korea [J].

Park, Hye Yoon ;

Song, In-Ae ;

Cho, Hyoung-Won ;

Oh, Tak Kyu .

JOURNAL OF SLEEP RESEARCH, 2022, 31 (02)

[36] The Effect of Intraaortic Balloon Pumping Under Venoarterial Extracorporeal Membrane Oxygenation on Mortality of Cardiogenic Patients: An Analysis Using a Nationwide Inpatient Database [J].

Aso, Shotaro ;

Matsui, Hiroki ;

Fushirni, Kiyohide ;

Yasunaga, Hideo .

CRITICAL CARE MEDICINE, 2016, 44 (11) :1974-1979

[37] Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation Results From an International, Multicenter Cohort Study [J].

Schrage, Benedikt ;

Becher, Peter Moritz ;

Bernhardt, Alexander ;

Bezerra, Hiram ;

Blankenberg, Stefan ;

Brunner, Stefan ;

Colson, Pascal ;

Cudemus Deseda, Gaston ;

Dabboura, Salim ;

Eckner, Dennis ;

Eden, Matthias ;

Eitel, Ingo ;

Frank, Derk ;

Frey, Norbert ;

Funamoto, Masaki ;

Gossling, Alina ;

Graf, Tobias ;

Hagl, Christian ;

Kirchhof, Paulus ;

Kupka, Danny ;

Landmesser, Ulf ;

Lipinski, Jerry ;

Lopes, Mathew ;

Majunke, Nicolas ;

Maniuc, Octavian ;

McGrath, Daniel ;

Mobius-Winkler, Sven ;

Morrow, David A. ;

Mourad, Marc ;

Noel, Curt ;

Nordbeck, Peter ;

Orban, Martin ;

Pappalardo, Federico ;

Patel, Sandeep M. ;

Pauschinger, Matthias ;

Pazzanese, Vittorio ;

Reichenspurner, Hermann ;

Sandri, Marcus ;

Schulze, P. Christian ;

H.G. Schwinger, Robert ;

Sinning, Jan-Malte ;

Aksoy, Adem ;

Skurk, Carsten ;

Szczanowicz, Lukasz ;

Thiele, Holger ;

Tietz, Franziska ;

Varshney, Anubodh ;

Wechsler, Lukas ;

Westermann, Dirk .

CIRCULATION, 2020, 142 (22) :2095-2106

[38] Acute brain injury risk prediction models in venoarterial extracorporeal membrane oxygenation patients with tree-based machine learning: An Extracorporeal Life Support Organization Registry analysis [J].

Kalra, Andrew ;

Bachina, Preetham ;

Shou, Benjamin L. ;

Hwang, Jaeho ;

Barshay, Meylakh ;

Kulkarni, Shreyas ;

Sears, Isaac ;

Eickhoff, Carsten ;

Bermudez, Christian A. ;

Brodie, Daniel ;

Ventetuolo, Corey E. ;

Kim, Bo Soo ;

Whitman, Glenn J. R. ;

Abbasi, Adeel ;

Cho, Sung-Min .

JTCVS OPEN, 2024, 20 :64-88

[39] In-hospital mortality and successful weaning from venoarterial extracorporeal membrane oxygenation: analysis of 5,263 patients using a national inpatient database in Japan [J].

Shotaro Aso ;

Hiroki Matsui ;

Kiyohide Fushimi ;

Hideo Yasunaga .

Critical Care, 20

[40] In-hospital mortality and successful weaning from venoarterial extracorporeal membrane oxygenation: analysis of 5,263 patients using a national inpatient database in Japan [J].

Aso, Shotaro ;

Matsui, Hiroki ;

Fushimi, Kiyohide ;

Yasunaga, Hideo .

CRITICAL CARE, 2016, 20

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