Outcomes after extracorporeal life support for postcardiotomy cardiogenic shock

被引:15
作者
Pozzi, Matteo [1 ]
Alvau, Francesca [1 ]
Armoiry, Xavier [2 ]
Grinberg, Daniel [1 ]
Hugon-Vallet, Elisabeth [3 ]
Koffel, Catherine [4 ,5 ]
Portran, Philippe [4 ,5 ]
Scollo, Giovanni [4 ,5 ]
Fellahi, Jean Luc [4 ,5 ]
Obadia, Jean Francois [1 ]
机构
[1] Claude Bernard Univ, Louis Pradel Cardiol Hosp, Dept Cardiac Surg, 28 Ave Doyen Lepine, F-69500 Lyon, France
[2] Univ Lyon, Edouard Herriot Hosp, Lyon Univ Hosp, Sch Pharm,ISPB,UMR CNRS 5510,MATEIS,Pharm Dept, Lyon, France
[3] Claude Bernard Univ, Louis Pradel Cardiol Hosp, Dept Cardiol, Lyon, France
[4] Claude Bernard Univ, Louis Pradel Cardiol Hosp, Dept Anesthesia, Lyon, France
[5] Claude Bernard Univ, Louis Pradel Cardiol Hosp, ICU, Lyon, France
关键词
cardiogenic shock; extracorporeal life support; postcardiotomy syndrome; MEMBRANE-OXYGENATION SUPPORT; LONG-TERM OUTCOMES; THERAPY; SOCIETY; MORTALITY;
D O I
10.1111/jocs.13985
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and Aim of the Study Extracorporeal life support (ECLS) may be necessary in refractory postcardiotomy cardiogenic shock (PCS) unresponsive to optimal medical treatment. We sought to analyze the results and temporal outcomes of ECLS for PCS. Methods We performed an observational analysis of our prospective database. In order to analyze the temporal trends of ECLS for PCS, patients were divided into two groups according to the period of ECLS implantation: Group I from January 2007-June 2012, Group II from July 2012-December 2017. The primary endpoint was survival to hospital discharge. Results During the study period, 90 patients required ECLS for PCS (Group I n = 29, 32%; Group II n = 61, 68%). Mean age was 57.5 +/- 15.0 years with 62% of males. Preoperative characteristics were comparable over the two periods. A high proportion of patients were in NYHA class III/IV (61%) or cardiogenic shock (22%). Group II showed a significantly higher proportion of miscellaneous cardiac surgery operations (23 vs 3%, P = 0.031). Crossclamp and cardiopulmonary bypass times were significantly shorter in Group II (85.4 vs 114.2 min, P = 0.023 and 135.2 vs 184.2 min, P = 0.022, respectively). The complication rate during ECLS support was comparable between both groups. Successful weaning from ECLS could be accomplished in 45 (50%) patients (Group I = 52% vs Group II = 49%, P = 0.822) after a mean support of 6.4 days. Thirty-five (39%) patients survived to hospital discharge (Group I = 41% vs Group II = 38%, P = 0.738). Conclusions Outcomes following ECLS remained stable over an 11-year period. ECLS may be limited in patients with severe preoperative cardiac dysfunction. Our data suggest that these patients may be better served with less invasive, percutaneous procedures.
引用
收藏
页码:74 / 81
页数:8
相关论文
共 29 条
  • [1] Postcardiotomy ECMO Support after High-risk Operations in Adult Congenital Heart Disease
    Acheampong, Benjamin
    Johnson, Jonathan N.
    Stulak, John M.
    Dearani, Joseph A.
    Kushwaha, Sudhir S.
    Daly, Richard C.
    Haile, Dawit T.
    Schears, Gregory J.
    [J]. CONGENITAL HEART DISEASE, 2016, 11 (06) : 751 - 755
  • [2] Meta-Analysis of the Outcome After Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Adult Patients
    Biancari, Fausto
    Perrotti, Andrea
    Dalen, Magnus
    Guerrieri, Mariapia
    Fiore, Antonio
    Reichart, Daniel
    Dell'Aquila, Angelo M.
    Gatti, Giuseppe
    Ala-Kokko, Tero
    Kinnunen, Eeva-Maija
    Tauriainen, Tuomas
    Chocron, Sidney
    Airaksinen, Juhani K. E.
    Ruggieri, Vito G.
    Brascia, Debora
    [J]. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2018, 32 (03) : 1175 - 1182
  • [3] Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: Changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database
    Brown, James M.
    O'Brien, Sean M.
    Wu, Changfu
    Sikora, Jo Ann H.
    Griffith, Bartley P.
    Gammie, James S.
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2009, 137 (01) : 82 - 90
  • [4] Long-term outcomes of extracorporeal membrane oxygenation support for postcardiotomy shock
    Chen, Shao-Wei
    Tsai, Feng-Chun
    Lin, Yu-Sheng
    Chang, Chih-Hsiang
    Chen, Dong-Yi
    Chou, An-Hsun
    Chen, Tien-Hsing
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2017, 154 (02) : 469 - +
  • [5] Duration of extracorporeal membrane oxygenation support and survival in cardiovascular surgery patients
    Distelmaier, Klaus
    Wiedemann, Dominik
    Binder, Christina
    Haberl, Thomas
    Zimpfer, Daniel
    Heinz, Gottfried
    Koinig, Herbert
    Felli, Alessia
    Steinlechner, Barbara
    Niessner, Alexander
    Laufer, Guenther
    Lang, Irene M.
    Goliasch, Georg
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2018, 155 (06) : 2471 - 2476
  • [6] Outcome in Patients Who Require Venoarterial Extracorporeal Membrane Oxygenation Support After Cardiac Surgery
    Elsharkawy, Hesham A.
    Li, Liang
    Sakr, Wael Ali
    Sessler, Daniel I.
    Bashour, C. Allen
    [J]. JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2010, 24 (06) : 946 - 951
  • [7] Contemporary mechanical circulatory support therapy for postcardiotomy shock
    Fukuhara, Shinichi
    Takeda, Koji
    Garan, Arthur Reshad
    Kurlansky, Paul
    Hastie, Jonathan
    Naka, Yoshifumi
    Takayama, Hiroo
    [J]. GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2016, 64 (04) : 183 - 191
  • [8] The RECOVER I: A multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support
    Griffith, Bartley P.
    Anderson, Mark B.
    Samuels, Louis E.
    Pae, Walter E., Jr.
    Naka, Yoshifumi
    Frazier, O. Howard
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2013, 145 (02) : 548 - 554
  • [9] Clinical outcomes in patients after extracorporeal membrane oxygenation support for post-cardiotomy cardiogenic shock: a single-centre experience of 92 cases
    Guihaire, Julien
    Van, Simon Dang
    Rouze, Simon
    Rosier, Sebastien
    Roisne, Antoine
    Langanay, Thierry
    Corbineau, Herve
    Verhoye, Jean-Philippe
    Flecher, Erwan
    [J]. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2017, 25 (03) : 363 - 369
  • [10] Extracorporeal membrane oxygenation for refractory cardiogenic shock after cardiac surgery: predictors of early mortality and outcome from 51 adult patients
    Hsu, Po-Shun
    Chen, Jia-Lin
    Hong, Guo-Jieng
    Tsai, Yi-Ting
    Lin, Chih-Yuan
    Lee, Chung-Yi
    Chen, Yu-Guang
    Tsai, Chien-Sung
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2010, 37 (02) : 328 - 333