%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.