Complications of Extracorporeal Membrane Oxygenation for Treatment of Cardiogenic Shock and Cardiac Arrest: A Meta-Analysis of 1,866 Adult Patients

Cheng, Richard; Hachamovitch, Rory; Kittleson, M.; Patel, Jignesh; Arabía, Francisco A.; Moriguchi, J.; Esmailian, F.; Azarbal, Babak

doi:10.1016/j.athoracsur.2013.09.008

Cited by 727 publications

(584 citation statements)

References 31 publications

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“…Potential complications include limb ischemia, compartment syndrome, stroke, acute kidney injury, bleeding, emboli, and infection [42,43]. Several factors must be considered in an individual basis such as age, co-morbidities, risk for complications, survivability, specific drug or chemical involved in the exposure, and time of hypoperfusion or cardiac arrest.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

et al. 2015

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Although there have been many developments related to specific strategies for treating patients after poisoning exposures, the mainstay of therapy remains symptomatic and supportive care. One of the most aggressive supportive modalities is extracorporeal membrane oxygenation (ECMO). Our goal was to describe the use of ECMO for toxicological exposures reported to the American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (Tox-IC). We performed a retrospective review of the ACMT ToxIC Registry from January 1, 2010 to December 31, 2013. Inclusion criteria included patients aged 0 to 89 years, evaluated between January 2010 through December 2013, and received ECMO for toxicological exposure. There were 26,271 exposures (60 % female) reported to the ToxIC Registry, 10 (0.0004 %) received ECMO: 4 pediatric (< 12 years), 2 adolescent (12-18 years), and 4 adults (>18 years). Time of initiation of ECMO ranged from 4 h to 4 days, with duration from 15 h to 12 days. Exposures included carbon monoxide/smoke inhalation (2), bitter almonds, methanol, and several medications including antihistamines (2), antipsychotic/ antidepressant (2), cardiovascular drugs (2), analgesics (2), sedative/hypnotics (2), and antidiabetics (2). Four ECMO patients received cardiopulmonary resuscitation (CPR) during their hospital course, and the overall survival rate was 80 %. ECMO was rarely used for poisoning exposures in the ACMT ToxIC Registry. ECMO was utilized for a variety of ages and for pharmaceutical and non-pharmaceutical exposures. In most cases, ECMO was administered prior to cardiovascular failure, and survival rate was high. If available, ECMO may be a valid treatment modality.

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Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

et al. 2015

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“…A high complication rate is usually expected in VA-ECMO patients [23], but poorly described in AFM patients [4,7,8,12]. Acute renal failure with need of dialysis, neurologic deficits, bleeding, hemolysis, sepsis, and lower limb-related complications occur in a substantial percentage of patients.…”

Section: Commentmentioning

confidence: 99%

Venoarterial Extracorporeal Membrane Oxygenation for Acute Fulminant Myocarditis in Adult Patients: A 5-Year Multi-Institutional Experience

Lorusso

Centofanti

Gelsomino

et al. 2016

The Annals of Thoracic Surgery

145

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Acute fulminant myocarditis (AFM) may represent a life-threatening event, characterized by rapidly progressive cardiac compromise that ultimately leads to refractory cardiogenic shock or cardiac arrest. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides effective cardiocirculatory support in this circumstance, but few clinical series are available about early and long-term results. Data from a multicenter study group are reported which analyzed subjects affected by AFM and treated with VA-ECMO during a 5-year period

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“…Published case series suggest that time to commencing VA-ECMO is critical to its success and should be limited to 30-60 min after cardiac arrest [7,8] whereas age, an independent predictor of in-hospital mortality, is arbitrarily defined [9]. Furthermore, while ECMO pump devices, tubing and cannulation procedures are becoming increasingly sophisticated and more compact mobile systems are available [10], the use of VA-ECMO is still associated with significant morbidity [11].…”

mentioning

confidence: 99%

Arteriovenous extracorporeal membrane oxygenation for cardiac arrest/cardiogenic shock

Åneman

Macdonald

2016

Intensive Care Med

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Complications of Extracorporeal Membrane Oxygenation for Treatment of Cardiogenic Shock and Cardiac Arrest: A Meta-Analysis of 1,866 Adult Patients

Cited by 727 publications

References 31 publications

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

Extracorporeal Membrane Oxygenation (ECMO) for Severe Toxicological Exposures: Review of the Toxicology Investigators Consortium (ToxIC)

Venoarterial Extracorporeal Membrane Oxygenation for Acute Fulminant Myocarditis in Adult Patients: A 5-Year Multi-Institutional Experience

Arteriovenous extracorporeal membrane oxygenation for cardiac arrest/cardiogenic shock

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