In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience

Giuseppe M. Raffa; Sandro Gelsomino; Niels Sluijpers; Paolo Meani; Khalid Alenizy; Ehsan Natour; Elham Bidar; Daniel Johnson; Maged Makhoul; Samuel Heuts; Pieter Lozekoot; Suzanne Kats; Rick Schreurs; Thijs Delnoij; Alice Montalti; Jan Willem Sels; Marcel van de Poll; Paul Roekaerts; Jos Maessen; Roberto Lorusso

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience

Giuseppe M. Raffa
, Sandro Gelsomino
, Niels Sluijpers
, Paolo Meani
, Khalid Alenizy
, Ehsan Natour
, Elham Bidar
, Daniel Johnson
, Maged Makhoul
, Samuel Heuts
, Pieter Lozekoot
, Suzanne Kats
, Rick Schreurs
, Thijs Delnoij
, Alice Montalti
, Jan Willem Sels
, Marcel van de Poll
, Paul Roekaerts
, Jos Maessen
, Roberto Lorusso

Cardiovascular Sciences

Research output: Contribution to journal › Article › peer-review

23 Citations (Scopus)

Abstract

Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center.

Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.

Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed.

Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65% were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed.

Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years.

Conclusions: Our experience confi rms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and
complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

Original language	English
Journal	Critical Care and Resuscitation
Publication status	Published - 1 Oct 2017

Cite this

Raffa, G. M., Gelsomino, S., Sluijpers, N., Meani, P., Alenizy, K., Natour, E., Bidar, E., Johnson, D., Makhoul, M., Heuts, S., Lozekoot, P., Kats, S., Schreurs, R., Delnoij, T., Montalti, A., Sels, J. W., van de Poll, M., Roekaerts, P., Maessen, J., & Lorusso, R. (2017). In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience. Critical Care and Resuscitation.

@article{b89c53fde55242d48c4c013263c75cc5,

title = "In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience",

abstract = "Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65\% were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed. Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22\%), isolated valve surgery (16\%), thoracic aorta surgery (4\%), a combination of CABG and valve surgery (21\%) or other surgery (24\%). PC-ECLS was achieved via central cannulation in 17\%, peripheral cannulation in 65\%, or by a combination in 17\%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49\% of patients, and 37\% survived to discharge. Post-operative bleeding (overall rate, 42\%) showed a trend towards a reduced rate over more recent years. Conclusions: Our experience confi rms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.",

author = "Raffa, \{Giuseppe M.\} and Sandro Gelsomino and Niels Sluijpers and Paolo Meani and Khalid Alenizy and Ehsan Natour and Elham Bidar and Daniel Johnson and Maged Makhoul and Samuel Heuts and Pieter Lozekoot and Suzanne Kats and Rick Schreurs and Thijs Delnoij and Alice Montalti and Sels, \{Jan Willem\} and \{van de Poll\}, Marcel and Paul Roekaerts and Jos Maessen and Roberto Lorusso",

year = "2017",

month = oct,

day = "1",

language = "English",

journal = "Critical Care and Resuscitation",

publisher = "Australasian Academy of Critical Care Medicine",

}

Raffa, GM, Gelsomino, S, Sluijpers, N, Meani, P, Alenizy, K, Natour, E, Bidar, E, Johnson, D, Makhoul, M, Heuts, S, Lozekoot, P, Kats, S, Schreurs, R, Delnoij, T, Montalti, A, Sels, JW, van de Poll, M, Roekaerts, P, Maessen, J & Lorusso, R 2017, 'In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience', Critical Care and Resuscitation.

TY - JOUR

T1 - In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients

T2 - the 2007-2017 Maastricht experience

AU - Raffa, Giuseppe M.

AU - Gelsomino, Sandro

AU - Sluijpers, Niels

AU - Meani, Paolo

AU - Alenizy, Khalid

AU - Natour, Ehsan

AU - Bidar, Elham

AU - Johnson, Daniel

AU - Makhoul, Maged

AU - Heuts, Samuel

AU - Lozekoot, Pieter

AU - Kats, Suzanne

AU - Schreurs, Rick

AU - Delnoij, Thijs

AU - Montalti, Alice

AU - Sels, Jan Willem

AU - van de Poll, Marcel

AU - Roekaerts, Paul

AU - Maessen, Jos

AU - Lorusso, Roberto

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65% were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed. Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years. Conclusions: Our experience confi rms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

AB - Objectives: The use of post-cardiotomy extracorporeal life support (PC-ECLS) has increased worldwide over the past years but a concurrent decrease in survival to hospital discharge has also been observed. We analysed use and outcome of PC-ECLS at the Maastricht University Medical Center. Design: A retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated. Setting: Patients who underwent PC-ECLS due to intra- or peri-operative cardiogenic shock or cardiac arrest were included. Descriptive statistics were analysed and frequency analysis and testing of group differences were performed. Participants: Eighty-six patients who received PC-ECLS between October 2007 and June 2017 were included. The mean age of the population was 65 years (range, 31–86 years), and 65% were men. Main outcome measures: Survival rates were calculated and PC-ECLS management data and complications were assessed. Results: Pre-ECLS procedures were isolated coronary artery bypass grafting (CABG) (22%), isolated valve surgery (16%), thoracic aorta surgery (4%), a combination of CABG and valve surgery (21%) or other surgery (24%). PC-ECLS was achieved via central cannulation in 17%, peripheral cannulation in 65%, or by a combination in 17%. The median duration of PC-ECLS was 5.0 days (IQR, 6.0 days). Weaning was achieved in 49% of patients, and 37% survived to discharge. Post-operative bleeding (overall rate, 42%) showed a trend towards a reduced rate over more recent years. Conclusions: Our experience confi rms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting.

UR - https://www.scopus.com/pages/publications/85040741034

M3 - Article

C2 - 29084502

JO - Critical Care and Resuscitation

JF - Critical Care and Resuscitation

ER -

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience

Abstract

Fingerprint

Cite this