• Mudit Kaushal, Joseph Schwartz, Nitish Gupta, Jay Im, Jonathan Leff, William A Jakobleff, and Galina Leyvi.
• Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Weill Cornell Medical Center, New York, NY. Electronic address: Muk9011@NYP.org.
• J. Cardiothorac. Vasc. Anesth. 2019 Apr 1; 33 (4): 910-917.

ObjectiveInvestigate how a multitude of patient demographics and extracorporeal membranous oxygenation (ECMO)-related complications affect 30-day survival or survival to discharge.DesignRetrospective observational study.SettingUrban university hospital, quaternary care center.ParticipantsPatients who underwent ECMO circulatory support from January 2012 to May 2016.InterventionsDate-based data extraction, univariate and multivariate regression analysis.Measurements And Main ResultsThe hospital database contained complete data for 235 adult patients who received venoarterial ECMO (74.04 %) and venovenous ECMO (25.96 %); 106 patients (45.11%) survived. The independent predictors significant in the odds of in-hospital mortality in a multiregression model were age (odds ratio [OR] = 1.028, p = 0.008), extracorporeal cardiopulmonary resuscitation (ECPR) after unsuccessful high-quality CPR (OR = 7.93, p =0.002), cardiogenic shock as the primary indication for circulatory support (OR = 2.58, p = 0.02), acute kidney injury (AKI) before ECMO initiation (OR = 7.53, p < 0.001), time spent on ECMO in days (OR = 1.08, p = 0.03), and limb ischemia (OR = 3.18, p = 0.047).ConclusionThe most significant findings of advancing age, time spent on ECMO, AKI, ECMO use in the setting of cardiogenic shock, ECPR, and limb ischemia as a complication of ECMO all independently increase the odds of in-hospital and 30-day mortality. To the best of the authors' knowledge, this study is the first to demonstrate a significant relationship between limb ischemia and mortality.Copyright © 2018 Elsevier Inc. All rights reserved.

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