In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience

Giuseppe M Raffa; Sandro Gelsomino; Niels Sluijpers; Paolo Meani; Khalid Alenizy; Ehsan Natour; Elham Bidar; Daniel M Johnson; Maged Makhoul; Samuel Heuts; Pieter Lozekoot; Suzanne Kats; Rick Schreurs; Thijs Delnoij; Alice Montalti; Jan W Sels; Marcel van de Poll; Paul Roekaerts; Jos Maessen; Roberto Lorusso

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience

Giuseppe M Raffa, Sandro Gelsomino, Niels Sluijpers, Paolo Meani, Khalid Alenizy, Ehsan Natour, Elham Bidar, Daniel M Johnson, Maged Makhoul, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan W Sels, Marcel van de Poll, Paul Roekaerts, Jos Maessen, Roberto Lorusso

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

Abstract

OBJECTIVES: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.

DESIGN: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.

SETTING: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed.

PARTICIPANTS: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31-86 years), and 65% were men.

MAIN OUTCOME MEASURES: Survival rates were calculated and PC-ECLS management data and complications were assessed.

RESULTS: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years.

CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

Original language	English
Pages (from-to)	53-61
Number of pages	9
Journal	Critical Care and Resuscitation
Volume	19
Issue number	Suppl 1
Publication status	Published - Oct 2017

Keywords

Journal Article

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Raffa, G. M., Gelsomino, S., Sluijpers, N., Meani, P., Alenizy, K., Natour, E., Bidar, E., Johnson, D. M., Makhoul, M., Heuts, S., Lozekoot, P., Kats, S., Schreurs, R., Delnoij, T., Montalti, A., Sels, J. W., Poll, M. V. D., Roekaerts, P., Maessen, J., & Lorusso, R. (2017). In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience. Critical Care and Resuscitation, 19(Suppl 1), 53-61. http://cicm.org.au/CICM_Media/CICMSite/CICM-Website/Resources/Publications/CCR%20Journal/Previous%20Editions/October%20Supplement%202017/ccr_19_OctSupp_011017-S53-S61.pdf

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title = "In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience",

abstract = "OBJECTIVES: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.DESIGN: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.SETTING: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed.PARTICIPANTS: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31-86 years), and 65% were men.MAIN OUTCOME MEASURES: Survival rates were calculated and PC-ECLS management data and complications were assessed.RESULTS: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years.CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.",

keywords = "Journal Article",

author = "Raffa, {Giuseppe M} and Sandro Gelsomino and Niels Sluijpers and Paolo Meani and Khalid Alenizy and Ehsan Natour and Elham Bidar and Johnson, {Daniel M} and Maged Makhoul and Samuel Heuts and Pieter Lozekoot and Suzanne Kats and Rick Schreurs and Thijs Delnoij and Alice Montalti and Sels, {Jan W} and Poll, {Marcel van de} and Paul Roekaerts and Jos Maessen and Roberto Lorusso",

year = "2017",

month = oct,

language = "English",

volume = "19",

pages = "53--61",

journal = "Critical Care and Resuscitation",

issn = "1441-2772",

publisher = "Australasian Academy of Critical Care Medicine",

number = "Suppl 1",

}

Raffa, GM, Gelsomino, S, Sluijpers, N, Meani, P, Alenizy, K, Natour, E , Bidar, E, Johnson, DM, Makhoul, M , Heuts, S, Lozekoot, P, Kats, S , Schreurs, R , Delnoij, T, Montalti, A, Sels, JW , Poll, MVD, Roekaerts, P, Maessen, J & Lorusso, R 2017, 'In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience', Critical Care and Resuscitation, vol. 19, no. Suppl 1, pp. 53-61. <http://cicm.org.au/CICM_Media/CICMSite/CICM-Website/Resources/Publications/CCR%20Journal/Previous%20Editions/October%20Supplement%202017/ccr_19_OctSupp_011017-S53-S61.pdf>

TY - JOUR

T1 - In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients

T2 - the 2007-2017 Maastricht experience

AU - Raffa, Giuseppe M

AU - Gelsomino, Sandro

AU - Sluijpers, Niels

AU - Meani, Paolo

AU - Alenizy, Khalid

AU - Natour, Ehsan

AU - Bidar, Elham

AU - Johnson, Daniel M

AU - Makhoul, Maged

AU - Heuts, Samuel

AU - Lozekoot, Pieter

AU - Kats, Suzanne

AU - Schreurs, Rick

AU - Delnoij, Thijs

AU - Montalti, Alice

AU - Sels, Jan W

AU - Poll, Marcel van de

AU - Roekaerts, Paul

AU - Maessen, Jos

AU - Lorusso, Roberto

PY - 2017/10

Y1 - 2017/10

N2 - OBJECTIVES: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.DESIGN: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.SETTING: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed.PARTICIPANTS: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31-86 years), and 65% were men.MAIN OUTCOME MEASURES: Survival rates were calculated and PC-ECLS management data and complications were assessed.RESULTS: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years.CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

AB - OBJECTIVES: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.DESIGN: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.SETTING: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed.PARTICIPANTS: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31-86 years), and 65% were men.MAIN OUTCOME MEASURES: Survival rates were calculated and PC-ECLS management data and complications were assessed.RESULTS: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years.CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

KW - Journal Article

M3 - Article

C2 - 29084502

SN - 1441-2772

VL - 19

SP - 53

EP - 61

JO - Critical Care and Resuscitation

JF - Critical Care and Resuscitation

IS - Suppl 1

ER -