• Małgorzata Celińska-Spodar, Mariusz Kuśmierczyk, Tomasz Zieliński, Małgorzata Jasińska, Piotr Kołsut, Paweł Litwiński, Ewa Sitkowska-Rysiak, Małgorzata Sobieszczańska-Małek, Jarosław Szymański, and Janina Stępińska.
• National Institute of Cardiology, Warsaw, Poland. mcelinska@ikard.pl
• Pol. Arch. Med. Wewn. 2021 Dec 22; 131 (12).

IntroductionData regarding venoarterial extracorporeal membrane oxygenation (VA ECMO) as a temporary circulatory support in cardiogenic shock (CS) for Central Europe are scarce.ObjectivesThe aim of the study was to disclose indications, in-hospital, and long-term (1-year) mortality along with risk factors.Patients And MethodsThe study is a retrospective investigation of patients who underwent VA ECMO for CS at a cardiosurgical tertiary center, from January 2013 to June 2018. A broad spectrum of pre- and postimplantation factors was tested using univariable analysis.ResultsA total of 198 patients met the inclusion criteria. The median (interquartile range) duration of support was 207 (91–339) hours, with no significant disparity among hospital survivors and nonsurvivors (P = 0.09). A total of 40.4% of patients died during ECMO support, while the joined in-hospital and 6-month mortality progressed to 65.2%, and 1-year mortality to 67.2%; 9% underwent a subsequent heart transplantation. Main adverse events were bleeding (76%), infection (56%), neurologic injury (15%), and limb ischemia (15%). Multiorgan failure was the most decisive risk factor of in-hospital mortality (odds ratio, 4.45; P <⁠0.001). Patients with postcardiotomy CS had a significantly lower out-of-hospital survival rate than the nonsurgical group (32.3% vs 45%; log-rank P = 0.037).ConclusionThe study showed survival benefit, despite frequent complications. The protocol focusing on proper candidate selection and timing can positively impact patient survival. Additional risk reduction can be achieved with a further increase of the team experience with ECMO.

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