TY - JOUR
T1 - Initiation of extracorporeal membrane oxygenation in the cardiac catheterization laboratory
T2 - The Mayo Clinic experience
AU - Ternus, Bradley
AU - Jentzer, Jacob
AU - Bohman, Kyle
AU - Barsness, Gregory
AU - Schears, Gregory
AU - Rihal, Charanjit
AU - Sandhu, Gurpreet
N1 - Publisher Copyright:
© 2020 HMP Communications. All rights reserved.
PY - 2020
Y1 - 2020
N2 - Introduction. Extracorporeal membrane oxygenation (ECMO) support is indicated for the management of patients with cardiogenic shock or refractory cardiac arrest in the cardiac catheterization laboratory. The aim of this study was to review the outcomes of patients initiated on ECMO support in the cardiac catheterization laboratory. Methods. We performed a retrospective analysis of adult patients (>18 years old) initiated on ECMO support in the cardiac catheterization laboratory from 2010-2017. Baseline demographics, clinical characteristics, procedural details, and indication for ECMO support were reviewed. The outcomes assessed included 30-day mortality, blood product transfusion, vascular injury, prolonged respiratory failure, stroke, ischemic bowel, renal failure requiring hemodialysis, and compartment syndrome. Results. Between January 1, 2010 and December 31, 2017, a total of 25 patients were cannulated for ECMO in the cardiac catheterization laboratory. The mean age was 61 years and 56% of patients were men. Cardiac arrest was the most frequent indication for ECMO support (64%), followed by cardiogenic shock (28%). The 30-day mortality rate was 40%. The most frequent complications associated with ECMO were the need for vascular surgery (52%) and renal failure requiring hemodialysis (36%). The univariate predictors of 30-day mortality were age (P=.02; unit odds ratio [OR], 1.08; 95% confidence interval [CI], 1.01-1.15), history of tobacco use (P=.04; OR, 6; 95% CI, 1.01-35.91), and Apache IV score (P=.02; unit OR, 1.02; 95% CI, 1.01-1.09). Conclusions. ECMO should be considered early during the resuscitation attempts of selected patients with ongoing cardiopulmonary resuscitation or refractory cardiogenic shock in the cardiac catheterization laboratory.
AB - Introduction. Extracorporeal membrane oxygenation (ECMO) support is indicated for the management of patients with cardiogenic shock or refractory cardiac arrest in the cardiac catheterization laboratory. The aim of this study was to review the outcomes of patients initiated on ECMO support in the cardiac catheterization laboratory. Methods. We performed a retrospective analysis of adult patients (>18 years old) initiated on ECMO support in the cardiac catheterization laboratory from 2010-2017. Baseline demographics, clinical characteristics, procedural details, and indication for ECMO support were reviewed. The outcomes assessed included 30-day mortality, blood product transfusion, vascular injury, prolonged respiratory failure, stroke, ischemic bowel, renal failure requiring hemodialysis, and compartment syndrome. Results. Between January 1, 2010 and December 31, 2017, a total of 25 patients were cannulated for ECMO in the cardiac catheterization laboratory. The mean age was 61 years and 56% of patients were men. Cardiac arrest was the most frequent indication for ECMO support (64%), followed by cardiogenic shock (28%). The 30-day mortality rate was 40%. The most frequent complications associated with ECMO were the need for vascular surgery (52%) and renal failure requiring hemodialysis (36%). The univariate predictors of 30-day mortality were age (P=.02; unit odds ratio [OR], 1.08; 95% confidence interval [CI], 1.01-1.15), history of tobacco use (P=.04; OR, 6; 95% CI, 1.01-35.91), and Apache IV score (P=.02; unit OR, 1.02; 95% CI, 1.01-1.09). Conclusions. ECMO should be considered early during the resuscitation attempts of selected patients with ongoing cardiopulmonary resuscitation or refractory cardiogenic shock in the cardiac catheterization laboratory.
KW - Cardiac arrest
KW - Cardiogenic shock
KW - Extracorporeal membrane oxygenation
UR - http://www.scopus.com/inward/record.url?scp=85078867130&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078867130&partnerID=8YFLogxK
M3 - Article
C2 - 31841997
AN - SCOPUS:85078867130
SN - 1042-3931
VL - 33
SP - 64
EP - 69
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 2
ER -