%0 Journal Article %T Post-cardiotomy extracorporeal life support: A cohort of cannulation in the general ward. %A Bari G %A Mariani S %A van Bussel BCT %A Ravaux J %A Di Mauro M %A Schaefer A %A Khalil J %A Pozzi M %A Botta L %A Pacini D %A Boeken U %A Samalavicius R %A Bounader K %A Hou X %A Bunge JJH %A Buscher H %A Salazar L %A Meyns B %A Mazeffi M %A Matteucci S %A Sponga S %A MacLaren G %A Russo C %A Formica F %A Sakiyalak P %A Fiore A %A Camboni D %A Raffa GM %A Diaz R %A Wang IW %A Jung JS %A Belohlavek J %A Pellegrino V %A Bianchi G %A Pettinari M %A Barbone A %A Garcia JP %A Shekar K %A Whitman G %A Lorusso R %A %J Artif Organs %V 0 %N 0 %D 2024 Jul 15 %M 39007409 %F 2.663 %R 10.1111/aor.14818 %X OBJECTIVE: 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.