Academic Journal
Temporary extracorporeal life support: single-centre experience with a new concept
| العنوان: | Temporary extracorporeal life support: single-centre experience with a new concept |
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| المؤلفون: | Nersesian, Gaik, Lewin, Daniel, Ott, Sascha, Schoenrath, Felix, Hrytsyna, Yuriy, Starck, Christoph, Spillmann, Frank, O'Brien, Benjamin, Falk, Volkmar, id_orcid:0 000-0002-7911-8620, Potapov, Evgenij, Lanmueller, Pia |
| المصدر: | Interdisciplinary Cardiovascular and Thoracic Surgery, 38 (4) |
| بيانات النشر: | Oxford University Press |
| سنة النشر: | 2024 |
| المجموعة: | ETH Zürich Research Collection |
| مصطلحات موضوعية: | Impella, Extracorporeal life support, Veno-arterial extracorporeal membrane oxygenation, ECMELLA, Cardiogenic shock |
| الوصف: | OBJECTIVES The combination of veno-arterial extracorporeal membrane oxygenation with a micro-axial flow pump (ECMELLA) is increasingly used for cardiogenic shock (CS) therapy. We report our experience with a novel single-artery access ECMELLA setup with either femoral (2.0) or jugular venous cannulation (2.1), respectively. METHODS Data from 67 consecutive CS patients treated with ECMELLA 2.0 (n = 56) and 2.1 (n = 11) from December 2020 and December 2022 in a tertiary cardiac center were retrospectively analyzed. RESULTS The mean age was 60.7 +/- 11 years, 56 patients (84%) were male. CS aetiology was acute on chronic heart failure (n = 35, 52%), myocardial infarction (n = 13, 19.5%), postcardiotomy syndrome (n = 16, 24%) and myocarditis (n = 3, 4.5%). Preoperatively 31 patients (46%) were resuscitated, 53 (79%) were on a ventilator and 60 (90%) were on inotropic support. The median vasoactive inotropic score was 32, and the mean arterial lactate was 8.1 mmol/l. In 39 patients (58%), veno-arterial extracorporeal membrane oxygenation was explanted after a median ECMELLA support of 4 days. Myocardial recovery was achieved in 18 patients (27%), transition to a durable left ventricular assist device in 16 (24%). Thirty-three patients (n = 33; 49%) died on support (25 on ECMELLA and 8 on Impella after de-escalation), 9 (13%) of whom were palliated. Axillary access site bleeding occurred in 9 patients (13.5%), upper limb ischaemia requiring surgical revision in 3 (4.5%). Axillary site infection occurred in 6 cases (9%), and perioperative stroke in 10 (15%; 6 hemorrhagic, 4 thromboembolic). CONCLUSIONS ECMELLA 2.0/2.1 is a feasible and effective therapy for severe CS. The single-artery cannulation technique is associated with a relatively low rate of access-related complications. ; ISSN:2753-670X |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/application/pdf |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/wos/001193858900003; http://hdl.handle.net/20.500.11850/667747 |
| DOI: | 10.3929/ethz-b-000667747 |
| الاتاحة: | https://hdl.handle.net/20.500.11850/667747 https://doi.org/10.3929/ethz-b-000667747 |
| Rights: | info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by/4.0/ ; Creative Commons Attribution 4.0 International |
| رقم الانضمام: | edsbas.A0A2BF56 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3929/ethz-b-000667747 |
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