Veno-arterial extracorporeal membrane oxygenation as cardiogenic shock therapy support in adult patients after heart surgery

Introduction: The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock.

Aim: The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed.

Material and methods: We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO. We compared the number of days on VA ECMO therapy, types of cardiac surgical procedures, and the frequency of VA ECMO complications such as coagulation disorders, lower limb ischemia, cardiac tamponade, and renal replacement therapy.

Results: There were 27 patients treated with VA ECMO during the study period. The mean patient age was 45 ±16 years. The hospital mortality rate of patients treated with VA ECMO therapy was 70% (19/27). There were no significant differences between the groups of survivors and non-survivors regarding age, gender, admission type and coexisting diseases. Type of cardiac surgical procedure had no influence on mortality or complications of therapy using VA ECMO.

Conclusions: The VA ECMO can be an effective form of therapy in some patients in postcardiotomy cardiogenic shock.