ABSTRACT

Extracorporeal membrane oxygenation (ECMO) appears to be a technically feasible rescue strategy for patients with respiratory and/or circulatory failure. This retrospective study was designed to evaluate and report the outcomes of patients who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock (RCS).

We conducted a retrospective, observational study of consecutive patients with RCS treated with VA-ECMO support at a single transplant center from March 2010 until November 2016. Overall, 189 patients underwent VA-ECMO for RCS (127 men, aged 56.6 ± 12.0 years; BSA, 1.85 ± 0.19). Demographic and clinical datas were reviewed for all patients.

The mean duration for VA-ECMO support was 172.8 ± 234.2 hours (range; 4–1920 hours). Succesful weaning (n=92; 48.6 %), overall survival (n=74, 39.2 %), vascular (n=21, 11.1%) and neurologic (n=11, 5.8%) complication rates were similar in literature.

Patients with VA-ECMO support are usually being lost due to multisystemic complications. Improvements in ECMO systems and advanced technical aspects result in better survival and less complication rates in critical patient population. In the last decade, use of hybrid ECMO systems and adjuvant catheter based interventions achieved a fast and safer recovery in this group. Advanced number of patients will use this chance in our country with improvement of experience in more centre.

Keywords: Extracorporeal Membrane Oxygenator, Refractory Cardiogenic Shock, Respiratuary Failure, Heart Failure