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Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump
B. Björnsdóttir, F. Biancari, M. Dalén, AM. Dell'Aquila, K. Jónsson, A. Fiore, G. Mariscalco, Z. El-Dean, G. Gatti, S. Zipfel, A. Perrotti, K. Bounader, K. Alkhamees, A. Loforte, A. Lechiancole, M. Pol, C. Spadaccio, M. Pettinari, D. De Keyzer,...
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- dospělí MeSH
- intraaortální balónková pumpa metody MeSH
- kardiochirurgické výkony * škodlivé účinky MeSH
- kardiogenní šok etiologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody MeSH
- podpůrné srdeční systémy * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- šok * etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVES: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP). DESIGN: A retrospective multicenter registry study. SETTING: At 19 cardiac surgery units. PARTICIPANTS: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group). MEASUREMENTS AND MAIN RESULTS: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78). CONCLUSIONS: This multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.
Cardiothoracic Department University Hospital of Udine Udine Italy
Clinica Montevergine GVM Care and Research Mercogliano Italy
Department of Cardiac Surgery Massachusetts General Hospital Harvard Medical School Boston MA
Department of Cardiac Surgery Sahlgrenska University Hospital Gothenburg Sweden
Department of Cardiothoracic Surgery Golden Jubilee National Hospital Glasgow United Kingdom
Department of Cardiothoracic Surgery Münster University Hospital Münster Germany
Department of Cardiothoracic Surgery Skane University Hospital and Lund University Lund Sweden
Department of Cardiovascular Surgery Universitätsklinikum Düsseldorf Düsseldorf Germany
Department of Cardiovascular Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Thoracic and Cardio Vascular Surgery University Hospital Jean Minjoz Besançon France
Division of Cardiac Surgery Anthea Hospital GVM Care and Research Bari Italy
Division of Cardiac Surgery Ospedali Riuniti Trieste Italy
Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital Rennes France
Division of Cardiothoracic and Vascular Surgery Robert Debré University Hospital Reims France
Hamburg University Heart Center Hamburg Germany
Heart and Lung Center Helsinki University Hospital University of Helsinki Helsinki Finland
Institute of Clinical and Experimental Medicine Prague Czech Republic
Citace poskytuje Crossref.org
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- $a Björnsdóttir, Björk $u Department of Cardiothoracic Surgery, Skane University Hospital and Lund University, Lund, Sweden
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- $a OBJECTIVES: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP). DESIGN: A retrospective multicenter registry study. SETTING: At 19 cardiac surgery units. PARTICIPANTS: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group). MEASUREMENTS AND MAIN RESULTS: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78). CONCLUSIONS: This multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.
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