ECMO after cardiac surgery: a single center study on survival and optimizing outcomes

被引:12
作者
Brewer, Jennifer M. [1 ]
Tran, Anthony [1 ]
Yu, Jielin [1 ]
Ali, M. Irfan [1 ]
Poulos, Constantine M. [1 ]
Gates, Jonathan [2 ]
Gluck, Jason [3 ]
Underhill, David [4 ]
机构
[1] Univ Connecticut, Dept Gen Surg, 263 Farmington Ave, Farmington, CT 06030 USA
[2] Hartford Healthcare, Div Trauma & Acute Care Surg, Hartford, CT USA
[3] Hartford Healthcare, Dept Cardiol & Mech Circulatory Support, Hartford, CT USA
[4] Hartford Healthcare, Div Cardiac Surg, Hartford, CT USA
关键词
Cardio-thoracic surgery; ECMO; Cardiac transplantation; Critical care; LVAD; Cardiac surgery; CARDIOPULMONARY-RESUSCITATION;
D O I
10.1186/s13019-021-01638-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The study purpose is to examine survival prognostic and extracorporeal membrane oxygenation (ECMO) application outcomes at our tertiary care center. Methods This is a retrospective analysis, January 2014 to September 2019. We analyzed 60 patients who underwent cardiac surgery and required peri-operative ECMO. All inpatients with demographic and intervention data was examined. 52 patients (86.6%) had refractory cardiogenic shock, 7 patients (11.6%) had pulmonary insufficiency, and 1 patient (1.6%) had hemorrhagic shock, all patients required either venous-arterial (VA) (n = 53, 88.3%), venous-venous (VV) (n = 5, 8.3%) or venous-arterial-venous (VAV) (n = 2, 3.3%) ECMO for hemodynamic support. ECMO parameters were analyzed and common postoperative complications were examined in the setting of survival with comorbidities. Results In-hospital mortality was 60.7% (n = 37). Patients who survived were younger (52 +/- 3.3 vs 66 +/- 1.5, p < 0.001) with longer hospital stays (35 +/- 4.0 vs 20 +/- 1.5, p < 0.03). Survivors required fewer blood products (13 +/- 2.3 vs 25 +/- 2.3, p = 0.02) with a net negative fluid balance (- 3.5 +/- 1.6 vs 3.4 +/- 1.6, p = 0.01). Cardiac re-operations worsened survival. Conclusion ECMO is a viable rescue strategy for cardiac surgery patients with a 40% survival to discharge rate. Careful attention to volume management and blood transfusion are important markers for potential survival.
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页数:7
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