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 ofvenoarterial extracorporeal membrane oxygenation (VA-ECMO)system support as treatment for postcardiotomy cardiogenic shockand ARDS.Methods: Between 2010 and 2013, 21 patients received ECMOsupport at our clinic. There were nine males (47.6%) and the meanage was 33.3±33.2 years (range 0.1-67 years). Cardiac surgeryincluded: (n=19); valve surgery (n=2), coronary artery bypassgrafting (CABG) (n=4), Bentall procedures (n=1), Congenitalcardiac surgery (n=12). Non-cardiac surgery; ARDS (n=1), Cardiacarrest (n=1). The CentriMag ECMO support was installed centrallyin six patients and peripherally in fifteen. Twenty patients incardiac patient were placed on venoarterial ECLS using a heparinbondedcircuit. One patient in cardiac patient were placed onvenovenous ECLS using a heparin-bonded circuit.Results: Median duration of support was three days (range 1-7days). Eleven patients were weaned from ECMO (52.3%), whereasseven patients died while on support mainly because of multipleorgan failure (63.6%). Ten patients died on ECMO supportbecause of multiple organ failure (47.6%). Four (14.6%) patientswere successfully discharged home. Complications included legischemia (n=2), bleeding (n=16), renal failure (n=3).Conclusion: Extracorporeal life support has complications uniqueto itself, but with time, these are likely to be overcome. The systemwas easy to install and manage.