Characterization of Extracorporeal Membrane Oxygenation for Pediatric Cardiac Arrest in the United States: Analysis of the Kids’ Inpatient Database

Central venoarterial extracorporeal membrane oxygenation has been used since the 1970s to support patients with cardiogenic shock following cardiac surgery. Despite this, in-hospital mortality is still high, and although rare, thrombus within the cardiac chambers or within the extracorporeal membrane oxygenation circuit is often fatal. Aprotinin is an antifibrinolytic available in Europe and Canada, though not currently in the United States. Due to historical safety concerns, use of aprotinin is generally limited and is commonly reserved for patients with the highest bleeding risk. Given the limited availability of aprotinin over the last decade, it is not surprising to find a complete absence of literature describing the use of venoarterial extracorporeal membrane oxygenation in the presence of aprotinin. We present three consecutive cases of rapid fatal intraoperative intracardiac thrombosis associated with post-cardiotomy central venoarterial extracorporeal membrane oxygenation in patients receiving aprotinin.

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Contemporary look at extracorporeal membrane oxygenation as a bridge to reoperative lung transplantation in the United States – a retrospective study

Transplant International ◽

10.1111/tri.13617 ◽

2020 ◽

Vol 33 (8) ◽

pp. 895-901 ◽

Cited By ~ 1

Author(s):

Jeremiah William Awori Hayanga ◽

Heather K. Hayanga ◽

James H. Fugett ◽

Kelsey A. Musgrove ◽

Ghulam Abbas ◽

...

Keyword(s):

United States ◽

Retrospective Study ◽

Extracorporeal Membrane Oxygenation ◽

Lung Transplantation ◽

The United States ◽

Membrane Oxygenation

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Trends in Extracorporeal Membrane Oxygenation for the Treatment of Acute Respiratory Distress Syndrome in the United States

Journal of Intensive Care Medicine ◽

10.1177/0885066616631956 ◽

2016 ◽

Vol 32 (9) ◽

pp. 535-539 ◽

Cited By ~ 9

Author(s):

Barret Rush ◽

Katie Wiskar ◽

Landon Berger ◽

Donald Griesdale

Keyword(s):

United States ◽

Acute Respiratory Distress Syndrome ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

International Classification Of Diseases ◽

The United States ◽

Relative Increase ◽

Membrane Oxygenation

Objectives: Our aim was to describe patient characteristics and trends in the use of extracorporeal membrane oxygenation (ECMO) for the treatment of acute respiratory distress syndrome (ARDS) in the United States from 2006 to 2011. Methods: We used the Nationwide Inpatient Sample to isolate all patients aged 18 years who had a discharge International Classification of Diseases, Ninth Revision diagnosis of ARDS, with and without procedure codes for ECMO, between 2006 and 2011. Results: We examined a total of 47 911 414 hospital discharges, representing 235 911 271 hospitalizations using national weights. Of the 1 479 022 patients meeting the definition of ARDS (representing 7 281 206 discharges), 775 underwent ECMO. There was a 409% relative increase in the use of ECMO for ARDS in the United States between 2006 and 2011, from 0.0178% to 0.090% ( P = .0041). Patients treated with ECMO had higher in-hospital mortality (58.6% vs 25.1%, P < .0001) and longer hospital stays (15.8 days vs 6.9 days, P < .0001). They were also younger (47.9 vs 66.4 years, P < .0001) and more likely to be male (62.2% vs 49.6%, P < .0001). The median time to initiate ECMO from the time of admission was 0.5 days (interquartile range [IQR] 4.9 days). Conclusion: There has been a dramatic increase in ECMO use for the treatment of ARDS in the United States.

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The changing population of the United States and use of extracorporeal membrane oxygenation

Journal of Surgical Research ◽

10.1016/j.jss.2013.04.027 ◽

2013 ◽

Vol 184 (1) ◽

pp. 572-576 ◽

Cited By ~ 14

Author(s):

Faisal G. Qureshi ◽

Hope T. Jackson ◽

Jessica Brown ◽

Mikael Petrosyan ◽

Peter T. Rycus ◽

...

Keyword(s):

United States ◽

Extracorporeal Membrane Oxygenation ◽

The United States ◽

Membrane Oxygenation

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Outcomes of Venoarterial Extracorporeal Membrane Oxygenation for Cardiac Arrest in Adult Patients in the United States

Journal of the American Heart Association ◽

10.1161/jaha.121.021406 ◽

2021 ◽

Author(s):

George Gill ◽

Jignesh K. Patel ◽

Diego Casali ◽

Georgina Rowe ◽

Hongdao Meng ◽

...

Keyword(s):

Cardiac Arrest ◽

Extracorporeal Membrane Oxygenation ◽

Hospital Mortality ◽

Coronary Intervention ◽

The United States ◽

Mortality Factors ◽

Factors Associated ◽

Predictors Of Mortality ◽

Membrane Oxygenation ◽

Nationally Representative

Background Factors associated with poor prognosis following receipt of extracorporeal membrane oxygenation (ECMO) in adults with cardiac arrest remain unclear. We aimed to identify predictors of mortality in adults with cardiac arrest receiving ECMO in a nationally representative sample. Methods and Results The US Healthcare Cost and Utilization Project's National Inpatient Sample was used to identify 782 adults hospitalized with cardiac arrest who received ECMO between 2006 and 2014. The primary outcome of interest was all‐cause in‐hospital mortality. Factors associated with mortality were analyzed using multivariable logistic regression. The overall in‐hospital mortality rate was 60.4% (n=472). Patients who died were older and more often men, of non‐White race, and with lower household income than those surviving to discharge. In the risk‐adjusted analysis, independent predictors of mortality included older age, male sex, lower annual income, absence of ventricular arrhythmia, absence of percutaneous coronary intervention, and presence of therapeutic hypothermia. Conclusions Demographic and therapeutic factors are independently associated with mortality in patients with cardiac arrest receiving ECMO. Identification of which patients with cardiac arrest may receive the utmost benefit from ECMO may aid with decision‐making regarding its implementation. Larger‐scale studies are warranted to assess the appropriate candidates for ECMO in cardiac arrest.

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