• J. Cardiothorac. Vasc. Anesth. · Aug 2022

    Multicenter Study

    Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation With and Without Intra-Aortic Balloon Pump.

    • Björk Björnsdóttir, Fausto Biancari, Magnus Dalén, Angelo M Dell'Aquila, Kristján Jónsson, Antonio Fiore, Giovanni Mariscalco, Zein El-Dean, Giuseppe Gatti, Svante Zipfel, Andrea Perrotti, Karl Bounader, Khalid Alkhamees, Antonio Loforte, Andrea Lechiancole, Marek Pol, Cristiano Spadaccio, Matteo Pettinari, Dieter De Keyzer, Henryk Welp, Giuseppe Speziale, Artur Lichtenberg, Vito G Ruggieri, Hakeem Yusuf, and Sigurdur Ragnarsson.
    • Department of Cardiothoracic Surgery, Skane University Hospital and Lund University, Lund, Sweden.
    • J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt B): 2876-2883.

    ObjectivesTo compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP).DesignA retrospective multicenter registry study.SettingAt 19 cardiac surgery units.ParticipantsA total of 615 adult patients who required VA-ECMO from 2010 to 2018. The patients were divided into 2 groups depending on whether they received VA-ECMO only (ECMO only group) or VA-ECMO plus IABP (ECMO-IABP group).Measurements And Main ResultsThe overall series mean age was 63 ± 13 years, and 33% were female. The ECMO-only group included 499 patients, and 116 patients were in the ECMO-IABP group. Urgent and/or emergent procedures were more common in the ECMO-only group. Central cannulation was performed in 47% (n = 54) in the ECMO-IABP group compared to 27% (n = 132) in the ECMO-only group. In the ECMO-IABP group, 58% (n = 67) were successfully weaned from ECMO, compared to 46% (n = 231) in the ECMO-only group (p = 0.026). However, in-hospital mortality was 63% in the ECMO-IABP group compared to 65% in the ECMO-only group (p = 0.66). Among 114 propensity score-matched pairs, ECMO-IABP group had comparable weaning rates (57% v 53%, p = 0.51) and in-hospital mortality (64% v 58%, p = 0.78).ConclusionsThis multicenter study showed that adjunctive IABP did not translate into better outcomes in patients treated with VA-ECMO for postcardiotomy shock.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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