- Journal
- JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
- Année
- 2021
- Volume
- 35
- Numéro
- 12
- Pages
- 3620-3625
- Mois
- DEC
- DOI
- 10.1053/j.jvca.2021.03.001
Abstract
Objective: Data on patients requiring a second run of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in patients affected by postcardiotomy cardiogenic shock (PCS) are very limited. The authors aimed to investigate the effect of a second run of VA-ECMO on PCS patient survival. Design: Retrospective analysis of an international registry. Setting: Multicenter study, tertiary university hospitals. Participants: Data on adult PCS patients receiving a second run of VA-ECMO. Measurements and Main Results: A total of 674 patients with a mean age of 62.9 +/- 12.7 years were analyzed, and 21 (3.1%) patients had a second run of VA-ECMO. None of them required more than two VA-ECMO runs. The median duration of VA-ECMO therapy was 135 hours (interquartile range [IQR] 61-226) in patients who did not require a VA-ECMO rerun. In the rerun VA-ECMO group the median overall duration of VA-ECMO therapy was 183 hours (IQR 107-344), and the median duration of the first run was 114 hours (IQR 66-169). Nine (42.9%) of the patients who required a second run of VA-ECMO died during VA-ECMO therapy, whereas five (23.8%) survived to hospital discharge. No differences between patients treated with single or second VA-ECMO runs were observed in terms of hospital mortality and late survival. In patients requiring a second VA-ECMO run, the actuarial survival estimates at three and 12 months after VA-ECMO weaning were 23.8% +/- 9.3% and 19.6% +/- 6.4%, respectively. Conclusions: Repeat VA-ECMO therapy is a valid treatment strategy for PCS patients. Early and late survivals are similar between patients who have undergone a single or second run of VA-ECMO. (C) 2021 Elsevier Inc. All rights reserved.