Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1—Adult patients

Roberto Lorusso, Giuseppe Maria Raffa, Khalid Alenizy, Niels Sluijpers, Maged Makhoul, Daniel Brodie, Mike McMullan, I. Wen Wang, Paolo Meani, Graeme MacLaren, Mariusz Kowalewski, Heidi Dalton, Ryan Barbaro, Xiaotong Hou, Nicholas Cavarocchi, Yih Sharng Chen, Ravi Thiagarajan, Peta Alexander, Bahaaldin Alsoufi, Christian A. BermudezAshish S. Shah, Jonathan Haft, David A. D'Alessandro, Udo Boeken, Glenn J.R. Whitman

Research output: Contribution to journalArticle

Abstract

Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances. Many factors have contributed to widespread ECMO use, including the relative ease of implantation, effectiveness, versatility, low cost relative to alternative devices, and potential for full, not just partial circulatory support. While there have been numerous publications detailing the short and midterm outcomes of ECMO support, specific reports about post-cardiotomy ECMO (PC-ECMO), are limited, single-center experiences. Etiology of cardiorespiratory failure leading to ECMO implantation, associated ECMO complications, and overall patient outcomes may be unique to the PC-ECMO population. Despite the rise in PC-ECMO use over the past decade, short-term survival has not improved. This report, therefore, aims to present a comprehensive overview of the literature with respect to the prevalence of ECMO use, patient characteristics, ECMO management, and in-hospital and early post-discharge patient outcomes for those treated for post-cardiotomy heart, lung, or heart-lung failure.

Original languageEnglish (US)
Pages (from-to)1125-1143
Number of pages19
JournalJournal of Heart and Lung Transplantation
Volume38
Issue number11
DOIs
StatePublished - Nov 2019

Keywords

  • cardiac surgery
  • cardiogenic shock
  • extracorporeal life support
  • extracorporeal membrane oxygenation
  • postoperative complications

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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  • Cite this

    Lorusso, R., Raffa, G. M., Alenizy, K., Sluijpers, N., Makhoul, M., Brodie, D., McMullan, M., Wang, I. W., Meani, P., MacLaren, G., Kowalewski, M., Dalton, H., Barbaro, R., Hou, X., Cavarocchi, N., Chen, Y. S., Thiagarajan, R., Alexander, P., Alsoufi, B., ... Whitman, G. J. R. (2019). Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1—Adult patients. Journal of Heart and Lung Transplantation, 38(11), 1125-1143. https://doi.org/10.1016/j.healun.2019.08.014