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