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Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study
JJH. Bunge, S. Mariani, C. Meuwese, BCT. van Bussel, M. Di Mauro, D. Wiedeman, D. Saeed, M. Pozzi, A. Loforte, U. Boeken, R. Samalavicius, K. Bounader, X. Hou, H. Buscher, L. Salazar, B. Meyns, D. Herr, S. Matteucci, S. Sponga, G. MacLaren, C....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, pozorovací studie, multicentrická studie
- MeSH
- časové faktory MeSH
- kardiochirurgické výkony * škodlivé účinky mortalita MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody škodlivé účinky MeSH
- mortalita v nemocnicích * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
OBJECTIVES: Most post-cardiotomy (PC) extracorporeal membrane oxygenation (ECMO) runs last less than 7 days. Studies on the outcomes of longer runs have provided conflicting results. This study investigates patient characteristics and short- and long-term outcomes in relation to PC ECMO duration, with a focus on prolonged (> 7 d) ECMO. DESIGN: Retrospective observational cohort study. SETTING: Thirty-four centers from 16 countries between January 2000 and December 2020. PATIENTS: Adults requiring post PC ECMO between 2000 and 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Characteristics, in-hospital, and post-discharge outcomes were compared among patients categorized by ECMO duration. Survivors and nonsurvivors were compared in the subgroup of patients with ECMO duration greater than 7 days. The primary outcome was in-hospital mortality. Two thousand twenty-one patients were included who required PC ECMO for 0-3 days ( n = 649 [32.1%]), 4-7 days ( n = 776 [38.3%]), 8-10 days ( n = 263 [13.0%]), and greater than 10 days ( n = 333 [16.5%]). There were no major differences in the investigated preoperative and procedural characteristics among ECMO duration groups. However, the longer ECMO duration category was associated with multiple complications including bleeding, acute kidney injury, arrhythmias, and sepsis. Hospital mortality followed a U-shape curve, with lowest mortality in patients with ECMO duration of 4-7 days ( n = 394, 50.8%) and highest in patients with greater than 10 days ECMO support ( n = 242, 72.7%). There was no significant difference in post-discharge survival between ECMO duration groups. In patients with ECMO duration greater than 7 days, age, comorbidities, valvular diseases, and complex procedures were associated with nonsurvival. CONCLUSIONS: Nearly 30% of PC ECMO patients were supported for greater than 7 days. In-hospital mortality increased after 7 days of support, especially in patients undergoing valvular and complex surgery, or who had complications, although the long-term post-discharge prognosis was comparable to PC ECMO patients with shorter support duration.
Adult Intensive Care Services The Prince Charles Hospital Brisbane QLD Australia
Cardiac ICU Johns Hopkins Hospital Baltimore MD
Cardiac Surgery Unit Cardiac Thoracic and Vascular Department Niguarda Hospital Milan Italy
Cardiac Surgery Unit IRCCS Humanitas Research Hospital Rozzano Milan Italy
Cardiac Surgery Unit University Hospital of Parma Parma Italy
Deparment of Cardiology Thoraxcenter Erasmus MC Rotterdam The Netherlands
Deparment of Surgical Sciences University of Turin Turin Italy
Department of Cardiac Surgery Leipzig Heart Center Leipzig Germany
Department of Cardiac Surgery Louis Pradel Cardiologic Hospital Lyon France
Department of Cardiac Surgery Medical Faculty Heinrich Heine University Duesseldorf Germany
Department of Cardiac Surgery Medical University of Vienna Vienna Austria
Department of Cardiac Surgery University Hospital St Pölten St Pölten Austria
Department of Cardio Thoracic Surgery University Hospital Henri Mondor Créteil Paris France
Department of Cardiology Fundación Cardiovascular de Colombia Bucaramanga Colombia
Department of Cardiology Pierangeli Hospital Pescara Italy
Department of Cardiothoracic Surgery University Medical Center Regensburg Regensburg Germany
Department of Cardiovascular Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Intensive Care Adults Erasmus MC Rotterdam The Netherlands
Department of Medicine and Surgery University of Parma Parma Italy
Department of Thoracic and Cardiovascular Surgery Korea University Anam Hospital Seoul South Korea
Departments of Medicine and Surgery University of Maryland Baltimore MD
Division of Cardiac Surgery Cardiothoracic Department University Hospital of Udine Udine Italy
Division of Cardiac Surgery IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Division of Cardiac Surgery Memorial Healthcare System Hollywood FL
Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital Rennes France
ECMO Unit Centro Cardiovascular Red Salud Santiago and Hospital San Juan de Dios Santiago Chile
Intensive Care Unit The Alfred Hospital Melbourne VIC Australia
IU Health Advanced Heart and Lung Care Indiana University Methodist Hospital Indianapolis IN
Ospedale del Cuore Fondazione Toscana G Monasterio Massa Italy
Citace poskytuje Crossref.org
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- $a Bunge, Jeroen J H $u Department of Intensive Care Adults, Erasmus MC, Rotterdam, The Netherlands $u Deparment of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands $1 https://orcid.org/0000000278974628
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- $a Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study / $c JJH. Bunge, S. Mariani, C. Meuwese, BCT. van Bussel, M. Di Mauro, D. Wiedeman, D. Saeed, M. Pozzi, A. Loforte, U. Boeken, R. Samalavicius, K. Bounader, X. Hou, H. Buscher, L. Salazar, B. Meyns, D. Herr, S. Matteucci, S. Sponga, G. MacLaren, C. Russo, F. Formica, P. Sakiyalak, A. Fiore, D. Camboni, GM. Raffa, R. Diaz, IW. Wang, JS. Jung, J. Belohlavek, V. Pellegrino, G. Bianchi, M. Pettinari, A. Barbone, JP. Garcia, K. Shekar, GJR. Whitman, D. Gommers, D. Dos Reis Miranda, R. Lorusso, Post-Cardiotomy Extracorporeal Life Support (PELS-1) Investigators
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