Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump
(2022) In Journal of Cardiothoracic and Vascular Anesthesia 36(8). p.2876-2883- Abstract
Objectives: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP). Design: A retrospective multicenter registry study. Setting: At 19 cardiac surgery units. Participants: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group). Measurements and Main Results: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent... (More)
Objectives: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP). Design: A retrospective multicenter registry study. Setting: At 19 cardiac surgery units. Participants: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group). Measurements and Main Results: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78). Conclusions: This multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiogenic shock, intra-aortic balloon pump, postcardiotomy, venoarterial extracorporeal membrane oxygenation
- in
- Journal of Cardiothoracic and Vascular Anesthesia
- volume
- 36
- issue
- 8
- pages
- 2876 - 2883
- publisher
- Elsevier
- external identifiers
-
- scopus:85126560459
- pmid:35304046
- ISSN
- 1053-0770
- DOI
- 10.1053/j.jvca.2022.02.006
- language
- English
- LU publication?
- yes
- id
- 5c593e75-8c59-4cc2-a957-d9f6608433ee
- date added to LUP
- 2022-06-09 10:38:39
- date last changed
- 2024-06-13 15:44:15
@article{5c593e75-8c59-4cc2-a957-d9f6608433ee,
abstract = {{<p>Objectives: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP). Design: A retrospective multicenter registry study. Setting: At 19 cardiac surgery units. Participants: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group). Measurements and Main Results: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78). Conclusions: This multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.</p>}},
author = {{Björnsdóttir, Björk and Biancari, Fausto and Dalén, Magnus and Dell'Aquila, Angelo M. and Jónsson, Kristján and Fiore, Antonio and Mariscalco, Giovanni and El-Dean, Zein and Gatti, Giuseppe and Zipfel, Svante and Perrotti, Andrea and Bounader, Karl and Alkhamees, Khalid and Loforte, Antonio and Lechiancole, Andrea and Pol, Marek and Spadaccio, Cristiano and Pettinari, Matteo and De Keyzer, Dieter and Welp, Henryk and Speziale, Giuseppe and Lichtenberg, Artur and Ruggieri, Vito G. and Yusuf, Hakeem and Ragnarsson, Sigurdur}},
issn = {{1053-0770}},
keywords = {{cardiogenic shock; intra-aortic balloon pump; postcardiotomy; venoarterial extracorporeal membrane oxygenation}},
language = {{eng}},
number = {{8}},
pages = {{2876--2883}},
publisher = {{Elsevier}},
series = {{Journal of Cardiothoracic and Vascular Anesthesia}},
title = {{Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump}},
url = {{http://dx.doi.org/10.1053/j.jvca.2022.02.006}},
doi = {{10.1053/j.jvca.2022.02.006}},
volume = {{36}},
year = {{2022}},
}