Veno-Arterial Extracorporeal Membrane Oxygenation for Refractory Cardiogenic Shock: Short-term Experience at a Tertiary Center
Anthony Lemaire, Cassandra soto, BS, Marlena Sabatino, Hirohisa Ikegami.
Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Cardiogenic shock and cardiac arrest are life-threatening emergencies. Mechanical circulatory support often provides the only option after medical therapy fails. The purpose of the study is to determine the impact of veno-arterial extracorporeal membrane oxygenation (VA ECMO) on patients who require cardiac support.
A retrospective chart review was performed at a single academic institution from January 1st, 2018 to May 31st, 2019.
A total of 48 patients were placed on VA ECMO with the majority of the patients being male (N=32) and the average age being 58±16 years old. A total of 23 patients (48%) were transferred from an outside hospital. The majority of the patients were placed on VA ECMO via the femoral artery and vein (N=40) with 8 patients having the cannulas placed centrally. Twenty-three of the patients (48%) underwent eCPR. The 25 patients that were placed on VA ECMO, excluding the eCPR patients, had a 48% survival rate to hospital discharge. The complications were bleeding (N=15, 60%) and limb ischemia (N=2, 8%). The duration on VA ECMO was 10.6± 9.5 days. The combined total group of patients on VA ECMO consisted of 48 patients with 32 total deaths for a mortality rate of 66%. The 23 patients who underwent eCPR had a 17% (N=4) survival rate.
VA ECMO provided rescue therapy for the patients. Our survival results for VA ECMO (48%), compare favorably with the ESLO 40% survival. The success with eCPR was low, which may reflect patient selection.
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