The short- and long-term risks of venoarterial extracorporeal membrane oxygenation watershed

Objectives: Survival after different short-term mechanical circulatory support is difficult to compare because various systems are used and patient disease severity is most often not adjusted for. This study compares the outcome after the use of Impella and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in refractory cardiogenic shock, adjusted for disease severity through the survival after the VA-ECMO (SAVE) score. Methods: Patients with refractory shock treated with either VA-ECMO or Impella between January 2003 and August 2015 were included. Data were analysed to assess short and long-term survival and complications. The SAVE score was calculated for the two groups and outcome was compared adjusted for the SAVE score. Results: There was no difference between VA-ECMO patients ( n=46) and Impella patients ( n=48) in mean age or renal failure. ECMO patients were more often intubated and had lower diastolic blood pressure at device implantation. ECMO patients had a lower SAVE score (–0.4 (6.5)) compared to Impella patients (4.1 (5.4)). There was no difference in intensive care unit survival between ECMO patients 65% (52–80) or Impella patients 63% (55–79), or long-term survival between groups. When stratified into worse (III–IV) or better SAVE class (I–II) there was no difference in survival between the groups. Conclusions: Short and long-term survival is not measurably different among patients treated with Impella or VA-ECMO due to refractory cardiogenic shock, after adjustment for disease severity through the SAVE score.

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The importance of perioperative and complication management in the treatment of pheochromocytoma crisis with venoarterial extracorporeal membrane oxygenation (V-A ECMO): a case report and review of the literature

Perfusion ◽

10.1177/02676591211049314 ◽

2021 ◽

pp. 026765912110493

Author(s):

Jiayi Chen ◽

Guangyong Jin ◽

Ying Zhu ◽

Wei Hu ◽

Huadong He ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Blood Circulation ◽

Patient Survival ◽

Surgical Removal ◽

Complication Management ◽

Pressure Management ◽

Membrane Oxygenation ◽

Venoarterial Extracorporeal Membrane Oxygenation ◽

Long Term Prognosis

Purpose: In this article, we aimed to elaborate on perioperative and complication management in treatment of pheochromocytoma crisis with extracorporeal membrane oxygenation (ECMO). Material and methods: We report a case of relatively rare grant paraganglioma-induced pheochromocytoma crisis leading to severe circulatory failure, treated with venoarterial extracorporeal membrane oxygenation (V-A ECMO) as a bridge to curative adrenalectomy. Weaning of ECMO was followed by successful surgical removal of the tumor, and patient survival. However, distal ischemia of the cannulated leg occurred during ECMO operation, which eventually led to amputation. In addition, the patient developed new cerebral infarction and left hemiplegia, half a month after paraganglioma resection. Conclusions: We believe that patients with pheochromocytoma crisis, who cannot maintain blood circulation, are eligible for V-A ECMO treatment. Moreover, care should be taken to prevent thrombosis and individualized and precise blood pressure management targets. Early detection and treatment of thrombosis is imperative to long-term prognosis of patients with ECMO.

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Effect of extracorporeal membrane oxygenation transport on short- and long-term survival in patients with acute respiratory distress syndrome

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2019.1669120 ◽

2019 ◽

Vol 33 (1) ◽

pp. 5-9

Author(s):

Desiree A. Steimer ◽

Omar Hernandez ◽

Gerald Ogola ◽

David P. Mason ◽

Gary S. Schwartz

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Term Survival ◽

Long Term Survival ◽

Membrane Oxygenation ◽

Short And Long Term

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Minimally invasive central venoarterial extracorporeal membrane oxygenation for long-term ambulatory support as a bridge to heart–lung transplant

Journal of Artificial Organs ◽

10.1007/s10047-020-01198-5 ◽

2020 ◽

Vol 23 (4) ◽

pp. 394-396

Author(s):

Sameer K. Singh ◽

Frank D’Ovidio ◽

A. Reshad Garan ◽

Daniel Brodie ◽

Joshua R. Sonett ◽

...

Keyword(s):

Minimally Invasive ◽

Extracorporeal Membrane Oxygenation ◽

Lung Transplant ◽

Heart Lung Transplant ◽

Membrane Oxygenation ◽

Venoarterial Extracorporeal Membrane Oxygenation

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P5734The outcome of intra-aortic balloon pumping support for acute myocardial infarction with extracorporeal membrane oxygenation therapy

European Heart Journal ◽

10.1093/eurheartj/ehz746.0674 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Kida ◽

S Hikoso ◽

D Nakatani ◽

S Suna ◽

T Dohi ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Extracorporeal Membrane Oxygenation ◽

Coronary Insufficiency ◽

Membrane Oxygenation ◽

Iabp Support ◽

Short And Long Term ◽

Long Term Mortality

Abstract Background It has been reported that intra-aortic balloon pumping (IABP) support for acute myocardial infarction (AMI) with cardiogenic shock did not reduce short and long-term mortality. However, the significance of IABP support for AMI patients with extracorporeal membrane oxygenation (ECMO) therapy remains unclear. The aim of this study was to investigate the effect of IABP support for the short and long-term outcome in AMI patients who received ECMO. Methods Using the database of the Osaka Acute Coronary Insufficiency Study (OACIS), 12,093 consecutive AMI patients were enrolled in this analysis. Among these, we analyzed 520 patients with ECMO. We classified the patients into two groups, patients who received IABP support [IABP group (n=460)] and patients who did not [no IABP group (n=60)]. Primary outcome was all-cause death. Results Study patients had following baseline clinical characteristics, age: 66.8±12.0 year old, male: 78.3%, diabetes mellitus: 41.0%, Killip class≥II: 66.2%, multi-vessel disease: 72.3%, peak creatine phosphokinase >3000IU/L: 68.1%. During a mean follow-up period of 349±625 days, Kaplan-Meier analysis revealed that the all-cause death was significantly lower in IABP group than no IABP group for 30-day (45.5% vs 72.7%, log-rank p<0.001) and long-term (66.2% vs 78.4%, Log rank p=0.005) follow-up period. Cox multivariate analysis revealed that IABP support was significantly associated with a reduced risk of mortality (Hazard ratio 0.445, 95% confidence interval 0.289 to 0.687, p<0.001). Conclusions IABP support for AMI patients with ECMO was significantly associated with reduced risks of the short and long-term mortality, suggesting that IABP support might contribute to improvement of the survival in AMI patients with ECMO.

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