Cardiothoracic & vascular anesthesia
Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study
Authors' conclusion
Nearly 30% of PC ECMO patients were supported for greater than 7 days. In-hospital mortality increased after 7 days of support, especially in patients undergoing valvular and complex surgery, or who had complications, although the long-term post-discharge prognosis was comparable to PC ECMO patients with shorter support duration.
Study context
- Population
- Adults requiring post-cardiotomy extracorporeal membrane oxygenation (ECMO), 34 centres in 16 countries, 2000–2020
- Participants
- 2,021 adults · 34 centres
- Exposure
- ECMO duration categories
- 0-3 daysn = 649
- 4-7 daysn = 776
- 8-10 daysn = 263
- >10 daysn = 333
- Outcome
- In-hospital mortality
Methodological detailsmulticentre, international, 34 centres in 16 countries, January 2000–December 2020
- Multicentre
- International
- 34 centres in 16 countries, January 2000–December 2020
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Post-discharge survival
- No significant difference between ECMO duration groups
Factors associated with nonsurvival, ECMO >7 days (subgroup)
- Age, comorbidities, valvular diseases and complex procedures associated with nonsurvival
Preoperative and procedural characteristics
- No major differences among ECMO duration groups
Safety
Complications (bleeding, AKI, arrhythmias, sepsis)
- Longer ECMO duration associated with multiple complications
Original publication
Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study. Crit Care Med. Published 7 June 2024. doi:10.
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