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 journalArticleAcademicpeer-review

20 Citations (Web of Science)

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 languageEnglish
Pages (from-to)327-369
Number of pages43
JournalAnnals of Thoracic Surgery
Volume111
Issue number1
DOIs
Publication statusPublished - 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

Cite this