Postcardiotomy venoarterial extracorporeal membrane oxygenation with and without intra-aortic balloon pump
El-Dean, Zein Yusuff, Hakeem
El-Dean, Zein
Yusuff, Hakeem
Abstract
Objectives: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP).
Design: A retrospective multicenter registry study.
Setting: At 19 cardiac surgery units.
Participants: A total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group).
Measurements and main results: The overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78).
Conclusions: This multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.
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Date
2022-02-11
Type
Article
Subject
Cardiogenic shock, Intra-aortic balloon pump, Postcardiotomy, Venoarterial extracorporeal membrane oxygenation
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Citation
Björnsdóttir, B., Biancari, F., Dalén, M., Dell'Aquila, A. M., Jónsson, K., Fiore, A., Mariscalco, G., El-Dean, Z., Gatti, G., Zipfel, S., Perrotti, A., Bounader, K., Alkhamees, K., Loforte, A., Lechiancole, A., Pol, M., Spadaccio, C., Pettinari, M., De Keyzer, D., Welp, H., … Ragnarsson, S. (2022). Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump. Journal of cardiothoracic and vascular anesthesia, 36(8 Pt B), 2876–2883. https://doi.org/10.1053/j.jvca.2022.02.006