TY - JOUR
T1 - Post-cardiotomy extracorporeal life support
T2 - A cohort of cannulation in the general ward
AU - Bari, Gabor
AU - Mariani, Silvia
AU - van Bussel, Bas C. T.
AU - Ravaux, Justine
AU - Di Mauro, Michele
AU - Schaefer, Anne
AU - Khalil, Jawad
AU - Pozzi, Matteo
AU - Botta, Luca
AU - Pacini, Davide
AU - Boeken, Udo
AU - Samalavicius, Robertas
AU - Bounader, Karl
AU - Hou, Xiaotong
AU - Bunge, Jeroen J. H.
AU - Buscher, Hergen
AU - Salazar, Leonardo
AU - Meyns, Bart
AU - Mazeffi, Michael
AU - Matteucci, Sacha
AU - Sponga, Sandro
AU - MacLaren, Graeme
AU - Russo, Claudio
AU - Formica, Francesco
AU - Sakiyalak, Pranya
AU - Fiore, Antonio
AU - Camboni, Daniele
AU - Raffa, Giuseppe Maria
AU - Diaz, Rodrigo
AU - Wang, I-wen
AU - Jung, Jae-Seung
AU - Belohlavek, Jan
AU - Pellegrino, Vin
AU - Bianchi, Giacomo
AU - Pettinari, Matteo
AU - Barbone, Alessandro
AU - Garcia, Jose P.
AU - Shekar, Kiran
AU - Whitman, Glenn
AU - Lorusso, Roberto
AU - Post-Cardiotomy Extracorporeal Life Support (PELS-1) Investigators
PY - 2024/11
Y1 - 2024/11
N2 - Objectives: Post-cardiotomy extracorporeal life support (ECLS) cannulation might occur in a general post-operative ward due to emergent conditions. Its characteristics have been poorly reported and investigated This study investigates the characteristics and outcomes of adult patients receiving ECLS cannulation in a general post-operative cardiac ward. Methods: The Post-cardiotomy Extracorporeal Life Support (PELS) is a retrospective (2000–2020), multicenter (34 centers), observational study including adult patients who required ECLS for post-cardiotomy shock. This PELS sub-analysis analyzed patients´ characteristics, in-hospital outcomes, and long-term survival in patients cannulated for veno-arterial ECLS in the general ward, and further compared in-hospital survivors and non-survivors. Results: The PELS study included 2058 patients of whom 39 (1.9%) were cannulated in the general ward. Most patients underwent isolated coronary bypass grafting (CABG, n = 15, 38.5%) or isolated non-CABG operations (n = 20, 51.3%). The main indications to initiate ECLS included cardiac arrest (n = 17, 44.7%) and cardiogenic shock (n = 14, 35.9%). ECLS cannulation occurred after a median time of 4 (2–7) days post-operatively. Most patients' courses were complicated by acute kidney injury (n = 23, 59%), arrhythmias (n = 19, 48.7%), and postoperative bleeding (n = 20, 51.3%). In-hospital mortality was 84.6% (n = 33) with persistent heart failure (n = 11, 28.2%) as the most common cause of death. No peculiar differences were observed between in-hospital survivors and nonsurvivors. Conclusions: This study demonstrates that ECLS cannulation due to post-cardiotomy emergent adverse events in the general ward is rare, mainly occurring in preoperative low-risk patients and after a postoperative cardiac arrest. High complication rates and low in-hospital survival require further investigations to identify patients at risk for such a complication, optimize resources, enhance intervention, and improve outcomes.
AB - Objectives: Post-cardiotomy extracorporeal life support (ECLS) cannulation might occur in a general post-operative ward due to emergent conditions. Its characteristics have been poorly reported and investigated This study investigates the characteristics and outcomes of adult patients receiving ECLS cannulation in a general post-operative cardiac ward. Methods: The Post-cardiotomy Extracorporeal Life Support (PELS) is a retrospective (2000–2020), multicenter (34 centers), observational study including adult patients who required ECLS for post-cardiotomy shock. This PELS sub-analysis analyzed patients´ characteristics, in-hospital outcomes, and long-term survival in patients cannulated for veno-arterial ECLS in the general ward, and further compared in-hospital survivors and non-survivors. Results: The PELS study included 2058 patients of whom 39 (1.9%) were cannulated in the general ward. Most patients underwent isolated coronary bypass grafting (CABG, n = 15, 38.5%) or isolated non-CABG operations (n = 20, 51.3%). The main indications to initiate ECLS included cardiac arrest (n = 17, 44.7%) and cardiogenic shock (n = 14, 35.9%). ECLS cannulation occurred after a median time of 4 (2–7) days post-operatively. Most patients' courses were complicated by acute kidney injury (n = 23, 59%), arrhythmias (n = 19, 48.7%), and postoperative bleeding (n = 20, 51.3%). In-hospital mortality was 84.6% (n = 33) with persistent heart failure (n = 11, 28.2%) as the most common cause of death. No peculiar differences were observed between in-hospital survivors and nonsurvivors. Conclusions: This study demonstrates that ECLS cannulation due to post-cardiotomy emergent adverse events in the general ward is rare, mainly occurring in preoperative low-risk patients and after a postoperative cardiac arrest. High complication rates and low in-hospital survival require further investigations to identify patients at risk for such a complication, optimize resources, enhance intervention, and improve outcomes.
KW - cardiac arrest
KW - cardiac surgery
KW - complications
KW - extracorporeal life support
KW - shock
KW - ward
KW - CARDIAC-ARREST
KW - RESUSCITATION
KW - GUIDELINE
KW - CONSENSUS
U2 - 10.1111/aor.14818
DO - 10.1111/aor.14818
M3 - Article
SN - 0160-564X
VL - 48
SP - 1355
EP - 1365
JO - Artificial Organs
JF - Artificial Organs
IS - 11
ER -