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Perfusion. 2015 Mar;30(2):113-8. doi: 10.1177/0267659114530455. Epub 2014 Apr 23.

Towards a proactive therapy utilizing the modern spectrum of extracorporeal life support: a single-centre experience.

Author information

1
Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.
2
Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands P.Weerwind@maastrichtuniversity.nl.
3
Department of Intensive Care, Maastricht University Medical Centre, Maastricht, the Netherlands Department of Cardiology - Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands.

Abstract

BACKGROUND:

We describe a single-centre experience of extracorporeal life support (ELS) for patients with severe and refractory cardiogenic shock, refractory cardiac arrest and severe respiratory failure.

METHODS:

Between September 2007 and September 2012, 56 intra-hospital and 10 inter-hospital adult patients were supported.

RESULTS:

The median ELS duration was 3 (0.9 - 6) days in venoarterial and 9.2 (7.4 - 24.4) days in venovenous supported patients. At hospital discharge and follow-up (12 and 40 months), survival among the respiratory (venovenous) patients and cardiac (venoarterial) patients was 84% and 38%, respectively. Survival in severe refractory cardiogenic shock patients was related to early initiation of ELS (<8 hours of onset of failure). A delay in initiating venoarterial ELS (>8 hours) and increased pre-ELS pH and lactate levels were associated with death in all cardiomyopathy patients, independent of infarct size.

CONCLUSIONS:

Our results exemplify the benefits of ELS as a bridge to initial stabilization of critically ill patients. Potentially, the early application of ELS technology can lower mortality and morbidity in patients with a regressive pathology.

KEYWORDS:

adult; extracorporeal life support; initiation time; survival rate

PMID:
24759930
DOI:
10.1177/0267659114530455
[Indexed for MEDLINE]

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