Using extracorporeal life support to resuscitate adult postcardiotomy cardiogenic shock: treatment strategies and predictors of short-term and midterm survival

Resuscitation
Meng-Yu WuKuo-Sheng Liu

Abstract

Postcardiotomy extracorporeal life support (ECLS) is a resource-demanding therapy with varied results among institutions. An organized protocol was necessary to improve the effectiveness of this therapy. A total of 110 patients received ECLS due to refractory postcardiotomy cardiogenic shock between January 2003 and June 2009, and were eligible for inclusion in this retrospective study. Preoperative, perioperative, and postoperative variables were collected, including the European system for cardiac operative risk evaluation (EuroSCORE) and markers of ECLS-related organ injuries. All variables were analyzed for possible associations with mortality in hospital, and after hospital discharge. The mean age, additive EuroSCORE, and left ventricular ejection fraction (LVEF) for all patients was 60 (+/-14) years, 9 (+/-6), and 43% (+/-20%) respectively. Sixty-seven patients were weaned from ECLS and 46 survived to hospital discharge. The mean duration of ECLS support was 143 h (+/-112 h). Multivariate analysis revealed that an age of >60 years, a necessity for postoperative continuous arteriovenous hemofiltration, a maximal serum total bilirubin >6 mg/dL, and a need for ECLS support for >110 h were independent predictors of in-hospita...Continue Reading

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Citations

Feb 8, 2014·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Yuan-His TsengMeng-Yu Wu
Sep 19, 2014·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Ta-Wei SuMeng-Yu Wu
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