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Postcardiotomy Veno...
Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Patients Aged 70 Years or Older
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- Biancari, Fausto (author)
- University of Oulu,Turku University Hospital
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- Saeed, Diyar (author)
- University Hospital of Düsseldorf
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- Fiore, Antonio (author)
- Henri Mondor Hospital
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- Dalén, Magnus (author)
- Karolinska Institutet
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- Ruggieri, Vito G. (author)
- Robert Debré University Hospital
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- Jónsson, Kristján (author)
- Sahlgrenska University Hospital
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- Gatti, Giuseppe (author)
- University Hospital Of Trieste
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- Zipfel, Svante (author)
- University Medical Center Hamburg-Eppendorf
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- Dell'Aquila, Angelo M. (author)
- University Hospital Münster
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- Chocron, Sidney (author)
- University Hospital Jean Minjoz
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- Bounader, Karl (author)
- Pontchaillou University Hospital
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- Amr, Gilles (author)
- Robert Debré University Hospital
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- Settembre, Nicla (author)
- University Hospital of Nancy
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- Pälve, Kristiina (author)
- Turku University Hospital
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- Loforte, Antonio (author)
- St. Orsola-Malpighi University Hospital
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- Gabrielli, Marco (author)
- University Hospital Of Trieste
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- Livi, Ugolino (author)
- University Hospital of Udine
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- Lechiancole, Andrea (author)
- University Hospital of Udine
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- Pol, Marek (author)
- Institute for Clinical and Experimental Medicine (IKEM)
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- Netuka, Ivan (author)
- Institute for Clinical and Experimental Medicine (IKEM)
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Spadaccio, Cristiano (author)
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- Pettinari, Matteo (author)
- Hospital Oost-Limburg
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- De Keyzer, Dieter (author)
- Hospital Oost-Limburg
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- Reichart, Daniel (author)
- University Medical Center Hamburg-Eppendorf
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- Ragnarsson, Sigurdur (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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Alkhamees, Khalid (author)
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- Lichtenberg, Artur (author)
- University Hospital of Düsseldorf
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- Fux, Thomas (author)
- Karolinska Institutet
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- El Dean, Zein (author)
- Glenfield Hospital
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- Fiorentino, Mariafrancesca (author)
- St. Orsola-Malpighi University Hospital
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- Mariscalco, Giovanni (author)
- Glenfield Hospital
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- Jeppsson, Anders (author)
- Sahlgrenska University Hospital
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- Welp, Henryk (author)
- University Hospital Münster
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Perrotti, Andrea (author)
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(creator_code:org_t)
- Elsevier BV, 2019
- 2019
- English 8 s.
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In: Annals of Thoracic Surgery. - : Elsevier BV. - 0003-4975 .- 1552-6259. ; 108:4, s. 1257-1264
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http://dx.doi.org/10...
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Abstract
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- Background: There is uncertainty whether venoarterial extracorporeal membrane oxygenation (VA-ECMO) should be used in older patients with cardiopulmonary failure after cardiac surgery. Methods: This was a retrospective multicenter study of 781 patients who required postcardiotomy VA-ECMO for cardiopulmonary failure after adult cardiac surgery from 2010 to 2018 at 19 cardiac surgery centers. A parallel systematic review with meta-analysis of the literature was performed. Results: The hospital mortality in the overall Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation (PC-ECMO) series was 64.4%. A total of 255 patients were 70 years old or older (32.7%), and their hospital mortality was significantly higher than in younger patients (76.1% vs 58.7%; adjusted odds ratio, 2.199; 95% confidence interval [CI], 1.536 to 3.149). Arterial lactate level greater than 6 mmol/L before starting VA-ECMO was the only predictor of hospital mortality among patients 70 years old or older in univariate analysis (82.6% vs 70.4%; P =.029). Meta-analysis of current and previous studies showed that early mortality after postcardiotomy VA-ECMO was significantly higher in patients aged 70 years or older compared with younger patients (odds ratio, 2.09; 95% CI, 1.59 to 2.75; 5 studies including 1547 patients; I2, 5.9%). The pooled early mortality rate among patients aged 70 years or older was 78.8% (95% CI, 74.1 to 83.5; 6 studies including 617 patients; I2, 41.8%). Two studies reported 1-year mortality (including hospital mortality) of 79.9% and 75.6%, respectively, in patients 70 years old or older. Conclusions: Advanced age should not be considered a contraindication for postcardiotomy VA-ECMO. However, in view of the high risk of early mortality, meaningful scrutiny is needed before using VA-ECMO after cardiac surgery in older patients.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- By the author/editor
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Biancari, Fausto
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Saeed, Diyar
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Fiore, Antonio
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Dalén, Magnus
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Ruggieri, Vito G ...
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Jónsson, Kristjá ...
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show more...
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Gatti, Giuseppe
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Zipfel, Svante
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Dell'Aquila, Ang ...
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Chocron, Sidney
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Bounader, Karl
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Amr, Gilles
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Settembre, Nicla
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Pälve, Kristiina
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Loforte, Antonio
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Gabrielli, Marco
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Livi, Ugolino
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Lechiancole, And ...
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Pol, Marek
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Netuka, Ivan
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Spadaccio, Crist ...
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Pettinari, Matte ...
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De Keyzer, Diete ...
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Reichart, Daniel
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Ragnarsson, Sigu ...
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Alkhamees, Khali ...
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Lichtenberg, Art ...
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Fux, Thomas
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El Dean, Zein
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Fiorentino, Mari ...
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Mariscalco, Giov ...
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Jeppsson, Anders
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Welp, Henryk
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Perrotti, Andrea
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Annals of Thorac ...
- By the university
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Lund University
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Karolinska Institutet