A Descriptive Analysis of Hybrid Cannulated Extracorporeal Life Support

Area of Science:

• Cardiovascular Sciences
• Critical Care Medicine
• Medical Technology

Background:

• Extracorporeal life support (ECLS) is vital for heart and lung failure, with increasing use.
• Hybrid ECLS, using a third cannula, is employed when standard methods are insufficient.
• Indications include severe hypoxemia, left ventricular issues, and hemodynamic instability.

Purpose of the Study:

• To analyze outcomes of hybrid ECLS in adult patients.
• To identify factors associated with survival in hybrid ECLS cases.

Main Methods:

• Retrospective review of adult hybrid ECLS cases at University Hospital Zurich (2007-2019).
• Inclusion criteria: initial triple cannulation for ECLS.
• Data collected from patient records and clinical information systems.

Main Results:

• 3.1% of ECLS cases (28/903) utilized initial hybrid cannulation.
• High in-hospital mortality rate of 67.9% for hybrid ECLS.
• Mortality varied significantly by indication: ARDS (36.4%) to cardiopulmonary resuscitation/post-cardiotomy (100%).

Conclusions:

• Hybrid ECLS is associated with high in-hospital mortality.
• Patient survival is linked to lower SAPS II scores and reduced need for platelet transfusions.
• Careful patient selection is crucial for optimizing outcomes in hybrid ECLS.