Outcomes in Patients Requiring Veno-Venous Extracorporeal Membrane Oxygenation After Cardiac Surgery: An Analysis From the PELS-1 Study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nardelli Pasquale, Mariani Silvia, De Piero Maria Elena, van Bussel Bas C T, Di Mauro Michele, Schaefer Ann-Kristin, Saeed Diyar, Pozzi Matteo, Botta Luca, Boeken Udo, Samalavicius Robertas, Bounader Karl, Hou Xiaotong, Bunge Jeroen J H, Buscher Hergen, Salazar Leonardo, Meyns Bart, Mazzeffi Michael A, Sacha Matteucci Marco L, Sponga Sandro, Ramanathan Kollengode, Russo Claudio, Formica Francesco, Sakiyalak Pranya, Fiore Antonio, Camboni Daniele, Raffa Giuseppe Maria, Diaz Rodrigo, Wang I-Wen, Jung Jae-Seung, Belohlavek Jan, Pellegrino Vin, Bianchi Giacomo, Pettinari Matteo, Barbone Alessandro, Garcia José P, Shekar Kiran, Whitman Glenn, Lorusso Roberto, PELS Investigators
Аннотация
METHODS: This retrospective, multicenter cohort study analyzes data from the PELS-1 registry, focusing on adult patients who required V-V ECMO following cardiac surgery. PELS-1 was conducted across 34 cardiac surgery centers in 16 countries from 2000 to 2020.
RESULTS: The study included 24 patients who received V-V ECMO over a total of 2163 patients requiring postocardiotomy extracorporeal support (1.1%). The median age was 64[50-69] years, and 16/24 (67%) were male. Median Euroscore II was 6.2[3.1-19.6]. Most patients required prolonged cardiopulmonary bypass (CPB) time (208[110-350] min). V-V ECMO was initiated in the ICU in 21 patients (87.5%) after a median of 5 [2-12] days postoperatively. ECMO support rapidly normalized gas exchange and lactate levels. However, complications were frequent: bleeding (10/22, 45.5%), acute kidney injury (10/24, 41.7%), pneumonia (10/24, 41.7%), and arrhythmias (7/24, 29.2%) were the most frequent ones. In-hospital mortality was high, with only 21.7% discharged alive. One-year survival was 12.5%.
CONCLUSIONS: Reported outcomes of patients receiving V-V ECMO after cardiac surgery are poor, despite effective correction of gas exchange. Early recognition of isolated respiratory failure and careful patient selection should be promoted. Further research is needed to optimize management in this high-risk population.