• Giuseppe M Raffa, Sandro Gelsomino, Niels Sluijpers, Paolo Meani, Khalid Alenizy, Ehsan Natour, Elham Bidar, Daniel M Johnson, Maged Makhoul, Samuel Heuts, Pieter Lozekoot, Suzanne Kats, Rick Schreurs, Thijs Delnoij, Alice Montalti, Jan W Sels, Marcel van de Poll, Paul Roekaerts, Jos Maessen, and Roberto Lorusso.
• Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
• Crit Care Resusc. 2017 Oct 1; 19 (Suppl 1): 53-61.

ObjectivesThe 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.DesignA retrospective study of a single-centre PC-ECLS cohort. Patient characteristics and in-hospital outcomes were evaluated.SettingPatients 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.ParticipantsEighty-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 MeasuresSurvival rates were calculated and PC-ECLS management data and complications were assessed.ResultsPre-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.ConclusionsOur experience confirms 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.

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