OA-ECMO/ECLS-001 Extracorporeal membrane oxygenation for cardiogenic shock after cardiac surgery: predictors of early mortality and outcome from 21 patients

Abstract

Background: We report our experience in the setting of venoarterial extracorporeal membrane oxygenation (VA-ECMO) system support as treatment for postcardiotomy cardiogenic shock and ARDS. Methods: Between 2010 and 2013, 21 patients received ECMO support at our clinic. There were nine males (47.6%) and the mean age was 33.3±33.2 years (range 0.1-67 years). Cardiac surgery included: (n=19); valve surgery (n=2), coronary artery bypass grafting (CABG) (n=4), Bentall procedures (n=1), Congenital cardiac surgery (n=12). Non-cardiac surgery; ARDS (n=1), Cardiac arrest (n=1). The CentriMag ECMO support was installed centrally in six patients and peripherally in fifteen. Twenty patients in cardiac patient were placed on venoarterial ECLS using a heparinbonded circuit. One patient in cardiac patient were placed on venovenous ECLS using a heparin-bonded circuit. Results: Median duration of support was three days (range 1-7 days). Eleven patients were weaned from ECMO (52.3%), whereas seven patients died while on support mainly because of multiple organ failure (63.6%). Ten patients died on ECMO support because of multiple organ failure (47.6%). Four (14.6%) patients were successfully discharged home. Complications included leg ischemia (n=2), bleeding (n=16), renal failure (n=3). Conclusion: Extracorporeal life support has complications unique to itself, but with time, these are likely to be overcome. The system was easy to install and manage.