التفاصيل البيبلوغرافية
| العنوان: |
Comparing Outcomes of Post-Cardiotomy Cardiogenic Shock Patients: On-Site Cannulation vs. Retrieval for V-A ECMO Support. |
| المؤلفون: |
Mihu, Mircea R., El Banayosy, Ahmed M., Harper, Michael D., Cain, Kaitlyn, Maybauer, Marc O., Swant, Laura V., Brewer, Joseph M., Schoaps, Robert S., Sharif, Ammar, Benson, Clayne, Freno, Daniel R., Bell, Marshall T., Chaffin, John, Elkins, Charles C., Vanhooser, David W., El Banayosy, Aly |
| المصدر: |
Journal of Clinical Medicine; Jun2024, Vol. 13 Issue 11, p3265, 9p |
| مصطلحات موضوعية: |
CARDIOGENIC shock, CORONARY artery bypass, ARTIFICIAL blood circulation, HEART assist devices, EXTRACORPOREAL membrane oxygenation, INTRA-aortic balloon counterpulsation |
| مستخلص: |
Background: Post-cardiotomy cardiogenic shock (PCCS) remains a life-threatening complication after cardiac surgery. Extracorporeal membrane oxygenation (ECMO) represents the mainstay of mechanical circulatory support for PCCS; however, its availability is limited to larger experienced centers, leading to a mismatch between centers performing cardiac surgery and hospitals offering ECMO management beyond cannulation. We sought to evaluate the outcomes and complications of PCCS patients requiring veno-arterial (V-A) ECMO cannulated at our hospital compared to those cannulated at referral hospitals. Methods: A retrospective analysis of PCCS patients requiring V-A ECMO was conducted between October 2014 to December 2022. Results: A total of 121 PCCS patients required V-A ECMO support, of which 62 (51%) patients were cannulated at the referring institutions and retrieved (retrieved group), and 59 (49%) were cannulated at our hospital (on-site group). The baseline demographics and pre-ECMO variables were similar between groups, except retrieved patients had higher lactic acid levels (retrieved group: 8.5 mmol/L ± 5.8 vs. on-site group: 6.6 ± 5; p = 0.04). Coronary artery bypass graft was the most common surgical intervention (51% in the retrieved group vs. 47% in the on-site group). There was no difference in survival-to-discharge rates between the groups (45% in the retrieved group vs. 51% in the on-site group; p = 0.53) or in the rate of patient-related complications. Conclusions: PCCS patients retrieved on V-A ECMO can achieve similar outcomes as those cannulated at experienced centers. An established network in a hub-and-spoke model is critical for the PCCS patients managed at hospitals without ECMO abilities to improve outcomes. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Clinical Medicine is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder