• Perfusion · Mar 2015

    Towards a proactive therapy utilizing the modern spectrum of extracorporeal life support: a single-centre experience.

    • A S Sharma, P W Weerwind, Y M Ganushchak, D W Donker, and J G Maessen.
    • Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.
    • Perfusion. 2015 Mar 1; 30 (2): 113-8.

    BackgroundWe describe a single-centre experience of extracorporeal life support (ELS) for patients with severe and refractory cardiogenic shock, refractory cardiac arrest and severe respiratory failure.MethodsBetween September 2007 and September 2012, 56 intra-hospital and 10 inter-hospital adult patients were supported.ResultsThe median ELS duration was 3 (0.9 - 6) days in venoarterial and 9.2 (7.4 - 24.4) days in venovenous supported patients. At hospital discharge and follow-up (12 and 40 months), survival among the respiratory (venovenous) patients and cardiac (venoarterial) patients was 84% and 38%, respectively. Survival in severe refractory cardiogenic shock patients was related to early initiation of ELS (<8 hours of onset of failure). A delay in initiating venoarterial ELS (>8 hours) and increased pre-ELS pH and lactate levels were associated with death in all cardiomyopathy patients, independent of infarct size.ConclusionsOur results exemplify the benefits of ELS as a bridge to initial stabilization of critically ill patients. Potentially, the early application of ELS technology can lower mortality and morbidity in patients with a regressive pathology.© The Author(s) 2014.

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