• J. Cardiothorac. Vasc. Anesth. · May 2020

    Multicenter Study

    Extracorporeal Cardiopulmonary Resuscitation: Outcomes and Complications at a Quaternary Referral Center.

    • Adam A Dalia, Shu Y Lu, Mauricio Villavicencio, David D'Alessandro, Ken Shelton, Gaston Cudemus, Michael Essandoh, and Jamel Ortoleva.
    • Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: aadalia@mgh.harvard.edu.
    • J. Cardiothorac. Vasc. Anesth. 2020 May 1; 34 (5): 1191-1194.

    ObjectiveAt a quaternary care center that regularly performs and cares for patients undergoing extracorporeal cardiopulmonary resuscitation (eCPR), a database of all adult patients who underwent eCPR with venoarterial extracorporeal membrane oxygenation (ECMO) over a 10-year period was reviewed. Seventy-one eCPR patients were analyzed to compare outcomes and complication rates. The authors hypothesized that evidence of end-organ injury, such as the need for continuous renal replacement therapy, in their institution's eCPR population would be associated with increased in-hospital mortality.DesignRetrospective chart review of prospectively collected data at a quaternary care center.SettingSingle quaternary academic referral center for ECMO.ParticipantsThe study comprised adult patients who underwent venoarterial ECMO for eCPR from 2009-2019 and for whom demographic data, survival data, and complication rates were available.InterventionsNone-this was a retrospective chart review.Measurements And Main ResultseCPR survival was 53.5% (38 of 71), and hospital survival was 33.8% (24 of 71). The most common complications were hemorrhage (26 of 67), renal failure (19 of 67), and neurologic injury (14 of 67). Of 19 patients requiring renal replacement therapy, only 1 survived to hospital discharge (5.3%) versus 23 of 48 patients without renal failure (47.9%) surviving to discharge (p = 0.001).ConclusionsIn this cohort of 71 patients who underwent eCPR, outcomes were promising; however, complication rates were high, and renal failure in particular demonstrated an extremely high mortality. These are single-institution results that should be followed up with larger multicenter cohorts of eCPR patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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