In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: The 2007–2017 maastricht experience

Giuseppe M. Raffa, Sandro Gelsomino, Niels Sluijpers, Paolo Meani, Khalid Alenizy, Ehsan Natour, Elham Bidar, Daniel M. Johnson, Maged Makhoul, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan W. Sels, Marcel Van De Poll, Paul Roekaerts, Jos Maessen, Roberto Lorusso

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65% were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed. Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years. Conclusions: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

Original languageEnglish
Pages (from-to)53-61
Number of pages9
JournalCritical Care and Resuscitation
Volume19
Publication statusPublished - Oct 1 2017

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Extracorporeal Membrane Oxygenation
Coronary Artery Bypass
Catheterization
Cardiogenic Shock
Weaning
Heart Arrest
Thoracic Aorta
Thoracic Surgery
Survival Rate
Retrospective Studies
Outcome Assessment (Health Care)
Hemorrhage
Survival

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine

Cite this

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients : The 2007–2017 maastricht experience. / Raffa, Giuseppe M.; Gelsomino, Sandro; Sluijpers, Niels; Meani, Paolo; Alenizy, Khalid; Natour, Ehsan; Bidar, Elham; Johnson, Daniel M.; Makhoul, Maged; Heuts, Samuel; Lozekoot, Pieter; Kats, Suzanne; Schreurs, Rick; Delnoij, Thijs; Montalti, Alice; Sels, Jan W.; Van De Poll, Marcel; Roekaerts, Paul; Maessen, Jos; Lorusso, Roberto.

In: Critical Care and Resuscitation, Vol. 19, 01.10.2017, p. 53-61.

Research output: Contribution to journalArticle

Raffa, GM, Gelsomino, S, Sluijpers, N, Meani, P, Alenizy, K, Natour, E, Bidar, E, Johnson, DM, Makhoul, M, Heuts, S, Lozekoot, P, Kats, S, Schreurs, R, Delnoij, T, Montalti, A, Sels, JW, Van De Poll, M, Roekaerts, P, Maessen, J & Lorusso, R 2017, 'In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: The 2007–2017 maastricht experience', Critical Care and Resuscitation, vol. 19, pp. 53-61.
Raffa, Giuseppe M. ; Gelsomino, Sandro ; Sluijpers, Niels ; Meani, Paolo ; Alenizy, Khalid ; Natour, Ehsan ; Bidar, Elham ; Johnson, Daniel M. ; Makhoul, Maged ; Heuts, Samuel ; Lozekoot, Pieter ; Kats, Suzanne ; Schreurs, Rick ; Delnoij, Thijs ; Montalti, Alice ; Sels, Jan W. ; Van De Poll, Marcel ; Roekaerts, Paul ; Maessen, Jos ; Lorusso, Roberto. / In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients : The 2007–2017 maastricht experience. In: Critical Care and Resuscitation. 2017 ; Vol. 19. pp. 53-61.
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abstract = "Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65{\%} were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed. Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22{\%}), isolated valve surgery (16{\%}), thoracic aorta surgery (4{\%}), a combination of CABG and valve surgery (21{\%}) or other surgery (24{\%}). PC-ECLS was achieved via central cannulation in 17{\%}, peripheral cannulation in 65{\%}, or by a combination in 17{\%}. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49{\%} of patients, and 37{\%} survived to discharge. Post-operative bleeding (overall rate, 42{\%}) showed a trend towards a reduced rate over more recent years. Conclusions: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.",
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AU - Raffa, Giuseppe M.

AU - Gelsomino, Sandro

AU - Sluijpers, Niels

AU - Meani, Paolo

AU - Alenizy, Khalid

AU - Natour, Ehsan

AU - Bidar, Elham

AU - Johnson, Daniel M.

AU - Makhoul, Maged

AU - Heuts, Samuel

AU - Lozekoot, Pieter

AU - Kats, Suzanne

AU - Schreurs, Rick

AU - Delnoij, Thijs

AU - Montalti, Alice

AU - Sels, Jan W.

AU - Van De Poll, Marcel

AU - Roekaerts, Paul

AU - Maessen, Jos

AU - Lorusso, Roberto

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