Universität zu Köln

Rustenbach, Christian Jorg, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, David, Lara, Ivanov, Borko ORCID: 0000-0001-8052-8232, Gerfer, Stephen, Gaisendrees, Christopher ORCID: 0000-0002-7232-3330, Wendt, Stefanie, Merkle, Julia, Seo, Joon, Sabashnikov, Anton, Rahmanian, Parwis, Kuhn, Elmar, Kroener, Axel, Bennink, Gerardus, Eghbalzadeh, Kaveh and Wahlers, Thorsten (2022). Risk factors associated with in-hospital mortality for patients with ECLS due to postcardiotomy cardiogenic shock after isolated coronary surgery. Artif. Organs, 46 (6). S. 1158 - 1165. HOBOKEN: WILEY. ISSN 1525-1594

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Abstract

Objectives Extracorporeal membrane oxygenation or extracorporeal life support (ECLS) in patients after cardiac surgery and postcardiotomy cardiogenic shock (PCS) is known to be associated with high mortality. Especially in patients after coronary artery bypass grafting (CABG) and PCS, ECLS is frequently established. The aim of this analysis was to evaluate factors associated with in-hospital mortality in patients treated with ECLS due to PCS after CABG. Methods Between August 2006 and January 2017, 92 consecutive patients with V-A ECLS due to PCS after isolated CABG were identified and included in this retrospective analysis. Patients were divided into survivors (S) and non-survivors (NS) and analyzed with risk factors of in-hospital mortality. Results In-hospital mortality added up to 61 patients (66%). Non-survivors were significantly older (60 +/- 812 (S) vs. 67 +/- 10 (NS); p = 0.013). Bilateral internal mammary artery graft was significantly more frequently used in S (23% (S) vs. 2% (NS); p = 0.001). After 24 h of ECLS support, median lactate levels were significantly higher in NS (1.9 (1.3; 3.5) mmol/L (S) vs. 3.5 (2.1; 6.3) mmol/L (NS); p = 0.001). NS suffered more often acute kidney injury requiring dialysis (42% (S) vs. 74% (NS); p = 0.002). Conclusion Mortality in patients with refractory PCS after CABG and consecutive ECLS support remains high. Failing end-organ recovery under ECLS despite optimized concomitant medical therapy is an indicator of adverse outcomes in this specific patient cohort. Moreover, total-arterial revascularization might be beneficial for cardiac recovery in patients suffering PCS after CABG and following ECLS.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rustenbach, Christian Jorg UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED David, Lara UNSPECIFIED UNSPECIFIED UNSPECIFIED Ivanov, Borko UNSPECIFIED orcid.org/0000-0001-8052-8232 UNSPECIFIED Gerfer, Stephen UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaisendrees, Christopher UNSPECIFIED orcid.org/0000-0002-7232-3330 UNSPECIFIED Wendt, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Seo, Joon UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroener, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Bennink, Gerardus UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-663242
DOI:	10.1111/aor.14166
Journal or Publication Title:	Artif. Organs
Volume:	46
Number:	6
Page Range:	S. 1158 - 1165
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1525-1594
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTRACORPOREAL MEMBRANE-OXYGENATION; CIRCULATORY SUPPORT; OUTCOMES; LIFE Multiple languages Engineering, Biomedical; Transplantation Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66324