Temporary circulatory support with extra corporeal membrane oxygenation in adults with refractory cardiogenic shock.
OBJECTIVE
Early and long-term survival in patients suffering from cardiogenic shock is poor. Treatment with mechanical assist devices is complicated and expensive but claim to improve survival. We reviewed our experience of venoarterial extracorporeal membrane oxygenation (ECMO) in patients with acute cardiogenic shock.


METHODS
ECMO was used in 52 patients with cardiogenic shock. They were divided into those not operated upon previously (n=19) and those having had cardiac surgery prior to circulatory collapse (n=33).


RESULTS
Twenty-six patients were weaned from ECMO. Early mortality for all patients was 48%. Mortality beyond 30 days was 5.8%, with no mortality in the non-cardiotomy group. Long-term survival for patients in the non-cardiotomy group was 63%, as compared to 33% in post-cardiotomy patients (p=0.07). Age over 55 years, female gender or cannulation site did not appear to influence survival.


CONCLUSIONS
Mortality for patients in cardiogenic shock is very high. Treatment with ECMO in patients with refractory cardiogenic shock can be performed with good survival especially in non-surgical patients.
Liden
H
H
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Wiklund
L
L
Haraldsson
A
A
Berglin
E
E
Hultman
J
J
Dellgren
G
G
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000401:mortality; D005260:Female; D006353:Heart-Assist Devices; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult