2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients

R. Lorusso; G. Whitman; M. Milojevic; G. Raffa; D.M. McMullan; U. Boeken; J. Haft; C.A. Bermudez; A.S. Shah; D.A. D'Alessandro

doi:10.1016/j.athoracsur.2020.07.009

2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients

R. Lorusso^*, G. Whitman, M. Milojevic, G. Raffa, D.M. McMullan, U. Boeken, J. Haft, C.A. Bermudez, A.S. Shah, D.A. D'Alessandro

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training. (C) 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization

Original language	English
Pages (from-to)	327-369
Number of pages	43
Journal	Annals of Thoracic Surgery
Volume	111
Issue number	1
DOIs	https://doi.org/10.1016/j.athoracsur.2020.07.009
Publication status	Published - 1 Jan 2021

Keywords

intraaortic balloon support
mechanical circulatory support
membrane-oxygenation support
near-infrared spectroscopy
postcardiotomy cardiogenic-shock
primary graft dysfunction
renal replacement therapy
respiratory-distress-syndrome
ventilator-associated pneumonia
ventricular assist device
MEMBRANE-OXYGENATION SUPPORT
VENTILATOR-ASSOCIATED PNEUMONIA
MECHANICAL CIRCULATORY SUPPORT
RESPIRATORY-DISTRESS-SYNDROME
INTRAAORTIC BALLOON SUPPORT
PRIMARY GRAFT DYSFUNCTION
VENTRICULAR ASSIST DEVICE
NEAR-INFRARED SPECTROSCOPY
RENAL REPLACEMENT THERAPY
POSTCARDIOTOMY CARDIOGENIC-SHOCK

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10.1016/j.athoracsur.2020.07.009

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title = "2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients",

abstract = "Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training. (C) 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization",

keywords = "intraaortic balloon support, mechanical circulatory support, membrane-oxygenation support, near-infrared spectroscopy, postcardiotomy cardiogenic-shock, primary graft dysfunction, renal replacement therapy, respiratory-distress-syndrome, ventilator-associated pneumonia, ventricular assist device, MEMBRANE-OXYGENATION SUPPORT, VENTILATOR-ASSOCIATED PNEUMONIA, MECHANICAL CIRCULATORY SUPPORT, RESPIRATORY-DISTRESS-SYNDROME, INTRAAORTIC BALLOON SUPPORT, PRIMARY GRAFT DYSFUNCTION, VENTRICULAR ASSIST DEVICE, NEAR-INFRARED SPECTROSCOPY, RENAL REPLACEMENT THERAPY, POSTCARDIOTOMY CARDIOGENIC-SHOCK",

author = "R. Lorusso and G. Whitman and M. Milojevic and G. Raffa and D.M. McMullan and U. Boeken and J. Haft and C.A. Bermudez and A.S. Shah and D.A. D'Alessandro",

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doi = "10.1016/j.athoracsur.2020.07.009",

language = "English",

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T1 - 2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients

AU - Lorusso, R.

AU - Whitman, G.

AU - Milojevic, M.

AU - Raffa, G.

AU - McMullan, D.M.

AU - Boeken, U.

AU - Haft, J.

AU - Bermudez, C.A.

AU - Shah, A.S.

AU - D'Alessandro, D.A.

PY - 2021/1/1

Y1 - 2021/1/1

N2 - Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training. (C) 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization

AB - Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training. (C) 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization

KW - intraaortic balloon support

KW - mechanical circulatory support

KW - membrane-oxygenation support

KW - near-infrared spectroscopy

KW - postcardiotomy cardiogenic-shock

KW - primary graft dysfunction

KW - renal replacement therapy

KW - respiratory-distress-syndrome

KW - ventilator-associated pneumonia

KW - ventricular assist device

KW - MEMBRANE-OXYGENATION SUPPORT

KW - VENTILATOR-ASSOCIATED PNEUMONIA

KW - MECHANICAL CIRCULATORY SUPPORT

KW - RESPIRATORY-DISTRESS-SYNDROME

KW - INTRAAORTIC BALLOON SUPPORT

KW - PRIMARY GRAFT DYSFUNCTION

KW - VENTRICULAR ASSIST DEVICE

KW - NEAR-INFRARED SPECTROSCOPY

KW - RENAL REPLACEMENT THERAPY

KW - POSTCARDIOTOMY CARDIOGENIC-SHOCK

U2 - 10.1016/j.athoracsur.2020.07.009

DO - 10.1016/j.athoracsur.2020.07.009

M3 - Article

C2 - 33036737

SN - 0003-4975

VL - 111

SP - 327

EP - 369

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 1

ER -

2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients

Abstract

Keywords

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