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DOI: 10.1055/s-0030-1269097
Peripheral ECMO therapy for postcardiotomy failure in cardiac surgery patients: A single centre experience
Objective: Peripheral extracorporeal membrane oxygenation (ECMO) via the femoral vessels offers cardiocirculatory support in patients with severe postcardiotomy myocardial failure. This single centre report analyses the outcomes in patients treated with peripheral ECMO after adult cardiac surgery.
Methods: Data were retrospectively obtained using our hospital database. All patients receiving peripheral ECMO support after surgery for acquired heart disease from January 2006 until July 2010 were included into the study. Logistic regression analysis was performed to identify independent predictors for 30-day all-cause mortality.
Results: A total of 70 patients with a mean age of 59.6±12.9 years were included into the analysis. Successful weaning from peripheral ECMO was achieved in 64.3% (45/70) after 77.4±45.9 hours of ECMO support. Overall 30-day mortality was 68.6% (48/70). In contrast, mortality was reduced in patients with successful ECMO weaning (30-day mortality 51.1% (23/45)). Older age at ECMO implantation was the only independent preoperative predictor of 30-day mortality, while type of surgery or cardioplegia, bypass or aortic cross-clamp time were not predictive. Occurrence of sepsis (p=0.008) and limb ischemia (p=0.015) worsened clinical outcomes as independent predictors in terms of higher 30-day mortality.
Conclusion: ECMO therapy provides an acceptable therapeutic strategy for severe postcardiotomy myocardial failure, but is still limited by high complication rates with less than 30% of patients being discharged from the hospital. Identification of clear predictors for clinical outcome is needed to lead the surgeons decision for ECMO therapy.