Korean J Thorac Cardiovasc Surg.  2009 Aug;42(4):464-472.

The In-hospital Clinical Outcomes of Extracorporeal Life Support after Adult Cardiovascular Surgery

• Yie K
• Na CY
• Oh SS
• Kim JH
• Ryu SM
• Park SM
• Cho SJ

Abstract

BACKGROUND: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. MATERIAL AND METHOD: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7+/-14.9 (range: 20~73) years old. The mean duration of extracorporeal life support system was 5.3+/-3.0 (range: 1~12) days. RESULT: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extracorporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival.
CONCLUSION
Although using extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery

Keyword

ECMO; VAD; PCPS; Cardiogenic shock; Cardiac surgery

MeSH Terms

Adult
Emergencies
Extracorporeal Membrane Oxygenation
Hemorrhage
Humans
Life Support Systems
Male
Medical Records
Renal Insufficiency
Renal Replacement Therapy
Retrospective Studies
Risk Factors
Shock, Cardiogenic
Survival Rate
Survivors