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Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1-Adult patients.

Abstract

Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances. Many factors have contributed to widespread ECMO use, including the relative ease of implantation, effectiveness, versatility, low cost relative to alternative devices, and potential for full, not just partial circulatory support. While there have been numerous publications detailing the short and midterm outcomes of ECMO support, specific reports about post-cardiotomy ECMO (PC-ECMO), are limited, single-center experiences. Etiology of cardiorespiratory failure leading to ECMO implantation, associated ECMO complications, and overall patient outcomes may be unique to the PC-ECMO population. Despite the rise in PC-ECMO use over the past decade, short-term survival has not improved. This report, therefore, aims to present a comprehensive overview of the literature with respect to the prevalence of ECMO use, patient characteristics, ECMO management, and in-hospital and early post-discharge patient outcomes for those treated for post-cardiotomy heart, lung, or heart-lung failure.

Authors+Show Affiliations

Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands. Electronic address: roberto.lorussobs@gmail.com.Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per I Trapianti e Terapie ad alta specializzazione), Palermo, Italy.Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands.Center for Acute Respiratory Care, Columbia University college of Physicians & Surgeon/New Yor Presbyterian Hospital, New York, New York.Cardiac Surgery Unit, Seattle Children Hospital, Seattle, Washington.Cardiac Transplantation and Mechanical Circulatory Support Unit, Indiana University School of Medicine, Health Methodist Hospital, Indianapolis, Indiana.Heart & Vascular Centre, Cardiology Department, Maastricht University Medical Centre, Maastricht, Netherlands.Cardiothoracic Intensive Care Unit, National University, Singapore, Singapore.Department of Cardiac Surgery, Antoni Jurasz Memorial University Hospital, Bydgoszcz, Poland.I.N.O.V.A. Fairfax Medical Centre, Adult and Pediatric ECMO Service, Falls Church, Virginia.Division of Pediatric Critical Care and Child Health Evaluation and Research Unit, Ann Arbor, Michigan.Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.Surgical Cardiac Care Unit, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.Cardiovascular Surgery & Pediatric Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan.Department of Cardiology, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.Department of Cardiology, Boston Children's Hospital; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Norton Children's Hospital, Louisville, Kentucky.Department of Cardiothoracic Surgery, Philadelphia, Pennsylvania.Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.Section of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.Cardio-Thoracic Surgery Department, Massachusetts Medical Centre, Boston, Massachusetts.Cardiovascular Surgery Unit, University of Düsseldorf, Düsseldorf, Germany.Cardiovascular Surgery Intensive Care Unit, Johns Hopkins Hospital, Baltimore, Maryland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31522913

Citation

Lorusso, Roberto, et al. "Structured Review of Post-cardiotomy Extracorporeal Membrane Oxygenation: Part 1-Adult Patients." The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, 2019.
Lorusso R, Raffa GM, Alenizy K, et al. Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1-Adult patients. J Heart Lung Transplant. 2019.
Lorusso, R., Raffa, G. M., Alenizy, K., Sluijpers, N., Makhoul, M., Brodie, D., ... Whitman, G. J. R. (2019). Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1-Adult patients. The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation, doi:10.1016/j.healun.2019.08.014.
Lorusso R, et al. Structured Review of Post-cardiotomy Extracorporeal Membrane Oxygenation: Part 1-Adult Patients. J Heart Lung Transplant. 2019 Aug 10; PubMed PMID: 31522913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1-Adult patients. AU - Lorusso,Roberto, AU - Raffa,Giuseppe Maria, AU - Alenizy,Khalid, AU - Sluijpers,Niels, AU - Makhoul,Maged, AU - Brodie,Daniel, AU - McMullan,Mike, AU - Wang,I-Wen, AU - Meani,Paolo, AU - MacLaren,Graeme, AU - Kowalewski,Mariusz, AU - Dalton,Heidi, AU - Barbaro,Ryan, AU - Hou,Xiaotong, AU - Cavarocchi,Nicholas, AU - Chen,Yih-Sharng, AU - Thiagarajan,Ravi, AU - Alexander,Peta, AU - Alsoufi,Bahaaldin, AU - Bermudez,Christian A, AU - Shah,Ashish S, AU - Haft,Jonathan, AU - D'Alessandro,David A, AU - Boeken,Udo, AU - Whitman,Glenn J R, Y1 - 2019/08/10/ PY - 2018/10/22/received PY - 2019/07/21/revised PY - 2019/08/05/accepted PY - 2019/9/17/entrez KW - cardiac surgery KW - cardiogenic shock KW - extracorporeal life support KW - extracorporeal membrane oxygenation KW - postoperative complications JF - The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation JO - J. Heart Lung Transplant. N2 - Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances. Many factors have contributed to widespread ECMO use, including the relative ease of implantation, effectiveness, versatility, low cost relative to alternative devices, and potential for full, not just partial circulatory support. While there have been numerous publications detailing the short and midterm outcomes of ECMO support, specific reports about post-cardiotomy ECMO (PC-ECMO), are limited, single-center experiences. Etiology of cardiorespiratory failure leading to ECMO implantation, associated ECMO complications, and overall patient outcomes may be unique to the PC-ECMO population. Despite the rise in PC-ECMO use over the past decade, short-term survival has not improved. This report, therefore, aims to present a comprehensive overview of the literature with respect to the prevalence of ECMO use, patient characteristics, ECMO management, and in-hospital and early post-discharge patient outcomes for those treated for post-cardiotomy heart, lung, or heart-lung failure. SN - 1557-3117 UR - https://www.unboundmedicine.com/medline/citation/31522913/Structured_review_of_post-cardiotomy_extracorporeal_membrane_oxygenation:_part_1-Adult_patients L2 - https://linkinghub.elsevier.com/retrieve/pii/S1053-2498(19)31632-8 DB - PRIME DP - Unbound Medicine ER -