Long-term Follow-up of Survivors of Postcardiotomy Circulatory Support

Sa, Ruzevich; Dg, Pennington; Kr, Kanter; Mt, Swartz; Lr, McBride; Df, Termuhlen

doi:10.1097/00002480-198804000-00008

Cited by 15 publications

(6 citation statements)

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“…They were non-randomized, retrospective, and confounded by selection bias with referral of less ill patients for revascularization. Small series of cardiogenic shock patients supported the use of ventricular assist devices using surrogates such as "return to work" (9). The SHOCK trial included functional status and quality of life as secondary end points to be evaluated in all hospital survivors.…”

Section: Discussionmentioning

confidence: 99%

Functional Status and Quality of Life After Emergency Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction

Sleeper

Ramanathan

Picard

et al. 2005

Journal of the American College of Cardiology

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Section: Discussionmentioning

confidence: 99%

Functional Status and Quality of Life After Emergency Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction

Sleeper

Ramanathan

Picard

et al. 2005

Journal of the American College of Cardiology

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“…According to Bartlett et al, cardiac ECMO is contraindicated “…when prolongation of life would not add to the quality of life, and it is an agonizing insensitive wasted effort if active organ failure is not reversible”(5). Disorders such as central nervous system damage, irreversible lung damage, chronic renal failure, and hepatic dysfunction are recognized contraindications for cardiac ECMO (6,7). Postoperative patients with uncontrolled hemorrhage, massive hemolysis, air embolization, or unsatisfactory repair are also generally recognized to be poor candidates for ECMO (7).…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation for Perioperative Support in Neonatal and Pediatric Cardiac Transplantation

et al. 1999

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Currently there is a lack of consensus on guidelines in the clinical application of extracorporeal membrane oxygenation (ECMO) in neonatal and pediatric cardiac transplantation patients. In this context, given the limited data presently available through the Extracorporeal Life Support Organization (ELSO) Registry, we conducted a preliminary survey to specifically evaluate the practice of using ECMO as a bridge to cardiac transplantation or as posttransplantation therapy for failure to wean from cardiopulmonary bypass or graft failure. We received responses to our questionnaire from 95 of 118 (81%) centers located in the U.S.A. and abroad. Of the 95 centers that responded, 36 were performing neonatal/pediatric cardiac transplants, with 29 centers reporting the concomitant use of ECMO to support cardiac transplant patients. There was wide variability in the responses from the 29 centers to a selected list of relative ECMO contraindications. However, only 7 centers had specific ECMO entry criteria for cardiac transplant patients. Fifteen of the 29 centers provided relevant data on cardiac transplant patients including the proportions of neonatal (11 of 37) and pediatric (63 of 217) patients requiring ECMO; neonatal (2 of 5) and pediatric (16 of 27) patients surviving to transplant; and neonatal (1 of 5) and pediatric (12 of 27) patients surviving to hospital discharge. These findings confirm the important role of ECMO in providing perioperative support in neonatal and pediatric cardiac transplantation patients. However, the lack of consensus among centers contributes to uncertainty in the decision making process to offer ECMO and to utilize ECMO effectively in this high risk population. We recommend that institution-specific information be collected, either using the ELSO Registry (or by a similar multicentric database) to develop specific guidelines for ECMO applications in cardiac transplant patients, and to carefully monitor and follow up EMCO treated patients to further evaluate the efficacy of this limited resource.

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“…Contraindications for cardiac ECMO vary among centers. Disorders such as CNS damage or neurologic dysfunction, malignancies, irreversible lung damage, chronic renal failure, and hepatic dysfunction are generally recognized contraindications for cardiac ECMO (10,19,42).…”

Section: Contraindicationsmentioning

confidence: 99%

“…Postoperative patients with uncontrolled hemorrhage, massive hemolysis, air embolization, intubation for more than 10 days, and unsatisfactory repair are also poor candidates (10,17,42).…”

Section: Contraindicationsmentioning

confidence: 99%

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Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

Wollenek

Czerny²,

Golej

1999

Artificial Organs

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Because children with severe myocardial dysfunction have limited therapeutic options, mechanical support of a failing heart is a matter of great interest. In the setting of cardiogenic shock or severe low cardiac output and hypoperfusion, extracorporeal membrane oxygenation (ECMO) can produce decisive improvements. The criteria for successful treatment include appropriate patient selection, improved surgical techniques and experience, higher recognition and anticipation of complications, and minimized delay in initiation of ECMO. Because the need for mechanical circulatory support may arise pre-, intra-, and postoperatively, every pediatric cardiac surgeon must be familiar with the principles and the surgical aspects of ECMO.

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Long-term Follow-up of Survivors of Postcardiotomy Circulatory Support

Cited by 15 publications

References 0 publications

Functional Status and Quality of Life After Emergency Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction

Functional Status and Quality of Life After Emergency Revascularization for Cardiogenic Shock Complicating Acute Myocardial Infarction

Extracorporeal Membrane Oxygenation for Perioperative Support in Neonatal and Pediatric Cardiac Transplantation

Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

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