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

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

ASJC Scopus subject areas

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

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    Raffa, G. M., Gelsomino, S., Sluijpers, N., Meani, P., Alenizy, K., Natour, E., Bidar, E., Johnson, D. M., Makhoul, M., Heuts, S., Lozekoot, P., Kats, S., Schreurs, R., Delnoij, T., Montalti, A., Sels, J. W., 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, 19, 53-61.