ECMO Retrieval Program: What Have We Learned So Far.
Ihor KrasivskyiClara GroßmannMarit DechowIlija DjordjevicBorko IvanovStephen GerferWalid BennourElmar KuhnAnton SabashnikovNavid MaderKaveh EghbalzadehThorsten WahlersPublished in: Life (Basel, Switzerland) (2023)
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for patients with cardiogenic shock or cardiac arrest. However, survival rates remain low. It is unclear to what extent ECMO patients benefit from the ECMO team learning curve. Therefore, we aimed to analyze our mobile ECMO program patients from the past seven years to evaluate if a learning curve benefits patients' outcomes. We analyzed 111 patients from our databank who were supported with a VA-ECMO and brought to our hospital from January 2015 to December 2021. Patients were divided into two groups: survival (n = 70) and non-survival (n = 41). As expected, complications after ECMO implantation were more severe in the non-survivor group. The incidence of thromboembolic events ( p = 0.002), hepatic failure ( p < 0.001), renal failure ( p = 0.002), dialysis ( p = 0.002) and systemic inflammatory response syndrome (SIRS, p = 0.044) occurred significantly more often compared with the survivor group. We were able to show that despite our extensive experience in terms of ECMO retrieval program the high mortality and morbidity rates stay fairly the same over the years. This displays that we have to focus even more on patient selection and ECMO indication.
Keyphrases
- extracorporeal membrane oxygenation
- end stage renal disease
- acute respiratory distress syndrome
- chronic kidney disease
- newly diagnosed
- ejection fraction
- inflammatory response
- peritoneal dialysis
- respiratory failure
- cardiac arrest
- healthcare
- emergency department
- metabolic syndrome
- cardiovascular disease
- intensive care unit
- risk factors
- insulin resistance
- adipose tissue
- quality improvement
- mechanical ventilation
- cardiovascular events