Timing and Strategy for Weaning from Venoarterial ECMO are Complex Issues

Federico Pappalardo, Marina Pieri, Blanca Arnaez Corada, Silvia Ajello, Giulio Melisurgo, Michele De Bonis, Alberto Zangrillo

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Weaning from venoarterial extracorporeal membrane oxygenation (VA ECMO) usually is performed without clear guidelines; yet, patients still die after removal of extracorporeal circulation because of inadequate heart or end-organ recovery. The aim of the study was to address the weaning procedure, analyzing the hemodynamic and echocardiographic picture of patients weaned and to identify predictors of poor outcome among this population. Design Observational study. Setting University hospital. Participants One hundred twenty-nine VA ECMO cases. Interventions None. Measurements and Main Results Forty-nine patients (38%) were weaned, 7 (5.4%) were bridged to a ventricular assist device, and 6 (5.2%) were listed for heart transplantation. Weaned patients showed a significant increase of pulse pressure (35 [0-50] mmHg before ECMO, 59 [53-67] mmHg at weaning, 61 [51-76] mmHg after ECMO (p

Original languageEnglish
Pages (from-to)906-911
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume29
Issue number4
DOIs
Publication statusPublished - 2015

Keywords

  • echocardiography
  • hemodynamics
  • venoarterial ECMO
  • weaning

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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