title: Results of extracorporeal life support implementation in routine clinical practice: single center experience.
abstract: OBJECTIVE
  To describe our experience in the clinical application of extracorporeal life support (ECLS) and analyze whether ECLS leads to acceptable clinical outcomes in patients with cardiac failure.
  
  
  METHODS
  Data from clinical database of University Hospital Center Zagreb, Croatia, on 75 patients undergoing ECLS support from 2009 to 2014 due to cardiac failure were retrospectively analyzed. Outcomes were defined as procedural and clinical outcomes. ECLS as a primary procedure and ECLS as a postcardiotomy procedure due to inability to wean from cardiopulmonary bypass were analyzed.
  
  
  RESULTS
  ECLS was used in 75 adult patients, and in 24 (32%) of those procedural success was noted. ECLS was implemented as a primary procedure in 36 patients and as a postcardiotomy procedure in 39 patients. Nine out of 39 (23.08%) patients had postcardiotomy ECLS after heart transplantation. Bleeding complications occurred in 30 (40%) patients, both in primary (11/36 patients) and postcardiotomy group (19/39 patients). ECLS was established by peripheral approach in 46 patients and by central cannulation in 27 patients. In 2 patients, combined cannulation was performed, with an inflow cannula placed into the right atrium and an outflow cannula placed into the femoral artery. Eleven patients treated with peripheral approach had ischemic complications.
  
  
  CONCLUSIONS
  ECLS is a useful tool in the treatment of patients with refractory cardiac failure and its results are encouraging in patients who otherwise have an unfavorable prognosis. Patient outcomes may be further improved by technological advances, more clinical experience in application of the technique, careful patient selection, and multidisciplinary approach in patient management.
authors.affiliation: Bojan Biočina, Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, bbiocina@kbc-zagreb.hr.
authors.forename: Bojan
authors.initials: B
authors.lastname: Biočina
authors.forename: Mate
authors.initials: M
authors.lastname: Petričević
authors.forename: Dražen
authors.initials: D
authors.lastname: Belina
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Gašparović
authors.forename: Lucija
authors.initials: L
authors.lastname: Svetina
authors.forename: Sanja
authors.initials: S
authors.lastname: Konosić
authors.forename: Alexandra
authors.initials: A
authors.lastname: White
authors.forename: Višnja
authors.initials: V
authors.lastname: Ivančan
authors.forename: Tomislav
authors.initials: T
authors.lastname: Kopjar
authors.forename: Davor
authors.initials: D
authors.lastname: Miličić
mesh_terms: D022561:Advanced Cardiac Life Support / Q000379:methods*; D000368:Aged; D002315:Cardiopulmonary Bypass; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies