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Have Changes in ECMO Technology Impacted Outcomes in Adult Patients Developing Postcardiotomy Cardiogenic Shock?
Author(s) -
Pokersnik Julie A.,
Buda Tiffany,
Bashour C. Allen,
GonzalezStawinski G.V.
Publication year - 2012
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2011.01409.x
Subject(s) - medicine , cardiogenic shock , extracorporeal membrane oxygenation , oxygenator , extracorporeal , membrane oxygenator , incidence (geometry) , adverse effect , anesthesia , surgery , cardiology , cardiopulmonary bypass , myocardial infarction , physics , optics
Extracorporeal membrane oxygenation (ECMO) technology has undergone several advancements over the last decade. We sought to compare current ECMO technology to older ones to determine how these technological improvements have impacted outcomes in patients suffering from postcardiotomy cardiogenic shock (PCS). Between 2005 and 2010, 49 patients received ECMO as support for PCS following elective cardiac surgery. Patients were divided into three groups. Group 1 (Gp 1, n = 11) patients received a Biomedicus pump with an Affinity oxygenator, Group 2 (Gp 2, n = 11) patients received a Biomedicus pump with a Quadrox D oxygenator, and Group 3 (Gp 3, n = 27) patients received a Rotaflow pump with a Quadrox D oxygenator. Groups were compared with regards to adverse events and ability to wean. Adverse event analysis showed no statistically significant difference between groups in incidence of stroke (p = 0.08), renal failure (p = 0.88), or bleeding requiring reexploration (p = 0.10). Changes in technology did little to improve weaning rates from ECMO (Gp 1 = 63.6%, Gp 2 = 45.5%, and Gp 3 = 55.6%). Similar trends were detected in hospital survival (Gp 1 = 27.3%, Gp 2 = 27.3%, and Gp 3 = 33.3%). Technology did impact oxygenator durability with Gp 1 requiring seven (63.6%) oxygenator exchanges compared to zero (0.0%) in Gp 2 and two (7.4%) in Gp 1. While advancements in ECMO technology have resulted in improved oxygenator durability, outcomes in patients requiring such support for PCS continue to be poor.