EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT FOR POSTCARDIOTOMY SHOCK: SINGLE CENTER EXPERIENCE

Area of Science:

• Cardiovascular Surgery
• Critical Care Medicine
• Pediatric Cardiology

Background:

• Post-cardiotomy shock (PCS) is a severe complication following cardiac surgery.
• Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a life-support technology used in critical cardiac conditions.

Purpose of the Study:

• To report the single-center experience with VA-ECMO for postcardiotomy shock in both pediatric and adult patients.
• To analyze survival outcomes and complications associated with VA-ECMO in PCS.

Main Methods:

• Retrospective study of 29 patients (pediatric and adult) treated with VA-ECMO for PCS from November 2006 to July 2019.
• Primary outcomes included survival to discharge and one-year survival.
• Patients were analyzed separately based on age group (pediatric vs. adult).

Main Results:

• Survival to discharge was 28% in pediatric patients and 18% in adult patients.
• One-year survival rates were also 28% for pediatric and 18% for adult groups.
• Bleeding was the most frequent complication in both groups; ECMO support averaged 6.2 days.

Conclusions:

• VA-ECMO provides a survival benefit for patients with refractory postcardiotomy shock, even with high complication rates.
• Despite a dismal prognosis, VA-ECMO serves as a crucial intervention for patients who would otherwise not survive.
• The study underscores the importance of VA-ECMO in managing severe PCS cases.