Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation after Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study
Issued Date
2024-10-01
Resource Type
ISSN
00903493
eISSN
15300293
Scopus ID
2-s2.0-85199753663
Pubmed ID
38856631
Journal Title
Critical Care Medicine
Volume
52
Issue
10
Start Page
e490
End Page
e502
Rights Holder(s)
SCOPUS
Bibliographic Citation
Critical Care Medicine Vol.52 No.10 (2024) , e490-e502
Suggested Citation
Bunge J.J.H., Mariani S., Meuwese C., Van Bussel B.C.T., Di Mauro M., Wiedeman D., Saeed D., Pozzi M., Loforte A., Boeken U., Samalavicius R., Bounader K., Hou X., Buscher H., Salazar L., Meyns B., Herr D., Matteucci S., Sponga S., Maclaren G., 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.J.R., Gommers D., Dos Reis Miranda D., Lorusso R., Heuts S., Ravaux J., Schaefer A.K., Conci L., Szalkiewicz P., Khalil J., Lehmann S., Obadia J.F., Kalampokas N., Jankuviene A., Flecher E., Sriranjan K., Mazzeffi M.A., Vedadi N., Di Eusanio M., Sorokin V., Ramanathan R., Costetti A., Schmid C., Castillo R., Mikulenka V., Grus T., Solinas M. Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation after Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study. Critical Care Medicine Vol.52 No.10 (2024) , e490-e502. e502. doi:10.1097/CCM.0000000000006349 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/101367
Title
Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation after Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study
Author(s)
Bunge J.J.H.
Mariani S.
Meuwese C.
Van Bussel B.C.T.
Di Mauro M.
Wiedeman D.
Saeed D.
Pozzi M.
Loforte A.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Buscher H.
Salazar L.
Meyns B.
Herr D.
Matteucci S.
Sponga S.
Maclaren G.
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.J.R.
Gommers D.
Dos Reis Miranda D.
Lorusso R.
Heuts S.
Ravaux J.
Schaefer A.K.
Conci L.
Szalkiewicz P.
Khalil J.
Lehmann S.
Obadia J.F.
Kalampokas N.
Jankuviene A.
Flecher E.
Sriranjan K.
Mazzeffi M.A.
Vedadi N.
Di Eusanio M.
Sorokin V.
Ramanathan R.
Costetti A.
Schmid C.
Castillo R.
Mikulenka V.
Grus T.
Solinas M.
Mariani S.
Meuwese C.
Van Bussel B.C.T.
Di Mauro M.
Wiedeman D.
Saeed D.
Pozzi M.
Loforte A.
Boeken U.
Samalavicius R.
Bounader K.
Hou X.
Buscher H.
Salazar L.
Meyns B.
Herr D.
Matteucci S.
Sponga S.
Maclaren G.
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.J.R.
Gommers D.
Dos Reis Miranda D.
Lorusso R.
Heuts S.
Ravaux J.
Schaefer A.K.
Conci L.
Szalkiewicz P.
Khalil J.
Lehmann S.
Obadia J.F.
Kalampokas N.
Jankuviene A.
Flecher E.
Sriranjan K.
Mazzeffi M.A.
Vedadi N.
Di Eusanio M.
Sorokin V.
Ramanathan R.
Costetti A.
Schmid C.
Castillo R.
Mikulenka V.
Grus T.
Solinas M.
Author's Affiliation
Korea University Anam Hospital
Siriraj Hospital
Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
National University Health System
Universitätsklinikum St. Pölten
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Fundación Cardiovascular de Colombia
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Ziekenhuis Oost-Limburg
Vilniaus Universitetas
Erasmus MC
Università Politecnica delle Marche
KU Leuven– University Hospital Leuven
UNSW Sydney
Hôpital Pontchaillou
Humanitas Research Hospital
Indiana University-Purdue University Indianapolis
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Herzzentrum Leipzig
Klinikum der Universität Regensburg und Medizinische Fakultät
Charles University
Asst Grande Ospedale Metropolitano Niguarda
Hospital San Juan de Dios, Santiago de Chile
Policlinico Universitario, Udine
University of Maryland, Baltimore (UMB)
Università degli Studi di Milano-Bicocca
Università degli Studi di Torino
Medizinische Universität Wien
The Alfred
Azienda Ospedaliero-Universitaria di Parma
Memorial Healthcare System
Università di Parma
The Prince Charles Hospital
The Johns Hopkins Hospital
Fondazione C.N.R. G. Monasterio Ospedale del Cuore
Louis Pradel Cardiologic Hospital
Pierangeli Clinic
Siriraj Hospital
Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
National University Health System
Universitätsklinikum St. Pölten
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
Fundación Cardiovascular de Colombia
Beijing Anzhen Hospital, Capital Medical University
CARIM School for Cardiovascular Disease
Ziekenhuis Oost-Limburg
Vilniaus Universitetas
Erasmus MC
Università Politecnica delle Marche
KU Leuven– University Hospital Leuven
UNSW Sydney
Hôpital Pontchaillou
Humanitas Research Hospital
Indiana University-Purdue University Indianapolis
IRCCS Azienda Ospedaliero-Universitaria di Bologna
Hôpital Henri Mondor
Herzzentrum Leipzig
Klinikum der Universität Regensburg und Medizinische Fakultät
Charles University
Asst Grande Ospedale Metropolitano Niguarda
Hospital San Juan de Dios, Santiago de Chile
Policlinico Universitario, Udine
University of Maryland, Baltimore (UMB)
Università degli Studi di Milano-Bicocca
Università degli Studi di Torino
Medizinische Universität Wien
The Alfred
Azienda Ospedaliero-Universitaria di Parma
Memorial Healthcare System
Università di Parma
The Prince Charles Hospital
The Johns Hopkins Hospital
Fondazione C.N.R. G. Monasterio Ospedale del Cuore
Louis Pradel Cardiologic Hospital
Pierangeli Clinic
Corresponding Author(s)
Other Contributor(s)
Abstract
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.