Outcomes in Patients Requiring VENO-Venous Extracorporeal Membrane Oxygenation After Cardiac Surgery: An Analysis From the PELS-1 Study
Issued Date
2026-01-01
Resource Type
ISSN
0160564X
eISSN
15251594
Scopus ID
2-s2.0-105027913333
Pubmed ID
41521169
Journal Title
Artificial Organs
Rights Holder(s)
SCOPUS
Bibliographic Citation
Artificial Organs (2026)
Suggested Citation
Nardelli P., Mariani S., De Piero M.E., van Bussel B.C.T., Di Mauro M., Schaefer A.K., Saeed D., Pozzi M., Botta L., Boeken U., Samalavicius R., Bounader K., Hou X., Bunge J.J.H., Buscher H., Salazar L., Meyns B., Mazzeffi M.A., Sacha Matteucci M.L., Sponga S., Ramanathan K., Russo C., Formica F., Sakiyalak P., Fiore A., Camboni D., Raffa G.M., Diaz R., Wang I.w., Jung J.S., Belohlavek J., Pellegrino V., Bianchi G., Pettinari M., Barbone A., Garcia J.P., Shekar K., Whitman G., Lorusso R. Outcomes in Patients Requiring VENO-Venous Extracorporeal Membrane Oxygenation After Cardiac Surgery: An Analysis From the PELS-1 Study. Artificial Organs (2026). doi:10.1111/aor.70093 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114464
Title
Outcomes in Patients Requiring VENO-Venous Extracorporeal Membrane Oxygenation After Cardiac Surgery: An Analysis From the PELS-1 Study
Author(s)
Nardelli P.
Mariani S.
De Piero M.E.
van Bussel B.C.T.
Di Mauro M.
Schaefer A.K.
Saeed D.
Pozzi M.
Botta L.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Bunge J.J.H.
Buscher H.
Salazar L.
Meyns B.
Mazzeffi M.A.
Sacha Matteucci M.L.
Sponga S.
Ramanathan K.
Russo C.
Formica F.
Sakiyalak P.
Fiore A.
Camboni D.
Raffa G.M.
Diaz R.
Wang I.w.
Jung J.S.
Belohlavek J.
Pellegrino V.
Bianchi G.
Pettinari M.
Barbone A.
Garcia J.P.
Shekar K.
Whitman G.
Lorusso R.
Mariani S.
De Piero M.E.
van Bussel B.C.T.
Di Mauro M.
Schaefer A.K.
Saeed D.
Pozzi M.
Botta L.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Bunge J.J.H.
Buscher H.
Salazar L.
Meyns B.
Mazzeffi M.A.
Sacha Matteucci M.L.
Sponga S.
Ramanathan K.
Russo C.
Formica F.
Sakiyalak P.
Fiore A.
Camboni D.
Raffa G.M.
Diaz R.
Wang I.w.
Jung J.S.
Belohlavek J.
Pellegrino V.
Bianchi G.
Pettinari M.
Barbone A.
Garcia J.P.
Shekar K.
Whitman G.
Lorusso R.
Author's Affiliation
UNSW Sydney
Charles University
University of Virginia
Erasmus MC
Medizinische Universität Wien
Universiteit Maastricht
Università degli Studi di Palermo
Maastricht Universitair Medisch Centrum+
Vilniaus Universitetas
The Johns Hopkins Hospital
Università del Salento
San Raffaele Scientific Institute
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Humanitas Research Hospital
The Alfred
Siriraj Hospital
Klinikum der Universität Regensburg und Medizinische Fakultät
National University Health System
Asst Grande Ospedale Metropolitano Niguarda
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Fondazione IRCCS San Gerardo dei Tintori
Hôpital Pontchaillou
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Korea University Anam Hospital
The Prince Charles Hospital
Departement Cardiovasculaire Wetenschappen
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Policlinico Universitario, Udine
Clínica Las Condes
Ziekenhuis Oost-Limburg
Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
Methodist Hospital Indianapolis
Memorial Healthcare System
Fundación Cardiovascular de Colombia
Helios Hospital Krefeld
Louis Pradel Cardiologic Hospital
Ospedale del Cuore Fondazione Toscana “G. Monasterio”
Charles University
University of Virginia
Erasmus MC
Medizinische Universität Wien
Universiteit Maastricht
Università degli Studi di Palermo
Maastricht Universitair Medisch Centrum+
Vilniaus Universitetas
The Johns Hopkins Hospital
Università del Salento
San Raffaele Scientific Institute
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Humanitas Research Hospital
The Alfred
Siriraj Hospital
Klinikum der Universität Regensburg und Medizinische Fakultät
National University Health System
Asst Grande Ospedale Metropolitano Niguarda
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Fondazione IRCCS San Gerardo dei Tintori
Hôpital Pontchaillou
Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona
Korea University Anam Hospital
The Prince Charles Hospital
Departement Cardiovasculaire Wetenschappen
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Policlinico Universitario, Udine
Clínica Las Condes
Ziekenhuis Oost-Limburg
Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
Methodist Hospital Indianapolis
Memorial Healthcare System
Fundación Cardiovascular de Colombia
Helios Hospital Krefeld
Louis Pradel Cardiologic Hospital
Ospedale del Cuore Fondazione Toscana “G. Monasterio”
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Acute respiratory failure after cardiac surgery is an uncommon complication, affecting morbidity and mortality. In these patients, respiratory extracorporeal membrane oxygenation (ECMO) support may be beneficial, as it may help reduce pulmonary vasoconstriction and the impact of respiratory pressures on the heart. Nevertheless, literature reports of postcardiotomy veno-venous (V-V) ECMO use are sporadic. Methods: This retrospective, multicenter cohort study analyzes data from the PELS-1 registry, focusing on adult patients who required V-V ECMO following cardiac surgery. PELS-1 was conducted across 34 cardiac surgery centers in 16 countries from 2000 to 2020. Results: The study included 24 patients who received V-V ECMO over a total of 2163 patients requiring postocardiotomy extracorporeal support (1.1%). The median age was 64[50–69] years, and 16/24 (67%) were male. Median Euroscore II was 6.2[3.1–19.6]. Most patients required prolonged cardiopulmonary bypass (CPB) time (208[110–350] min). V-V ECMO was initiated in the ICU in 21 patients (87.5%) after a median of 5 [2–12] days postoperatively. ECMO support rapidly normalized gas exchange and lactate levels. However, complications were frequent: bleeding (10/22, 45.5%), acute kidney injury (10/24, 41.7%), pneumonia (10/24, 41.7%), and arrhythmias (7/24, 29.2%) were the most frequent ones. In-hospital mortality was high, with only 21.7% discharged alive. One-year survival was 12.5%. Conclusions: Reported outcomes of patients receiving V-V ECMO after cardiac surgery are poor, despite effective correction of gas exchange. Early recognition of isolated respiratory failure and careful patient selection should be promoted. Further research is needed to optimize management in this high-risk population.