title: Veno-arterial extracorporeal membrane oxygenation for short-term mechanical circulation support in adults with cardiogenic shock: a single centre experience.
abstract: BACKGROUND
  Patients suffering from cardiogenic shock, with no response to conventional therapy, may significantly improve when put on support devices such as extracorporeal membrane oxygenation (ECMO), which maintains systemic and pulmonary circulation, and decongests the heart. This publication presents authors' own experience in qualifying and treating patients with cardiogenic shock, with the use of veno-arterial (VA) ECMO modality.
  
  
  OBJECTIVE
  The main goal of the study was to analyse factors influencing outcome of VA ECMO therapy in patients with cardiogenic shock. Survival data were compared for patients surviving treatment (n = 12, 41%), and for patients who died while VA ECMO.
  
  
  METHODS
  Retrospective study included all patients treated between February 2009, when ECMO was first used in the clinic, and March 2015. Of those, 29 patients were treated with VA ECMO for respiratory support. Mean patient age was 42 years; 19 (66%) patients were male, and 10 (34%) patients were female.
  
  
  RESULTS
  Total in-hospital mortality rate was 59% (17/29). No difference was observed as to patient age, sex, body height, mode of hospital admission, comorbidities or left ventricular ejection fraction at hospital admission, when comparing survivors and patients who died despite treatment. The following parameters were analysed: number of days on VA ECMO, troponin levels during first days from treatment onset, platelet transfusions, and duration of mechanical ventilation. No significant differences were observed between the groups. Surviving patients were significantly longer hospitalised (p = 0.016), including a longer stay in the intensive care unit (p = 0.03).
  
  
  CONCLUSIONS
  VA ECMO is an acceptable therapy for patients in a severe state of cardiogenic shock. In-hospital mortality rate was 59%, and 41% patients (12 subjects) were successfully treated with VA ECMO in course of cardiogenic shock.
authors.affiliation: Oddział Anestezjologii i Intensywnej Terapii Medycznej Krakowskiego Szpitala Specjalistycznego im. Jana Pawła II w Krakowie. r.musial@aclex.com.pl.
authors.forename: Robert
authors.initials: R
authors.lastname: Musiał
authors.forename: Paweł
authors.initials: P
authors.lastname: Moncznik
authors.forename: Paweł
authors.initials: P
authors.lastname: Śmiałek
authors.forename: Jarosław
authors.initials: J
authors.lastname: Stoliński
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Rafał
authors.initials: R
authors.lastname: Drwiła
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
keywords: cardiogenic shock; extracorporeal life support; extracorporeal membrane oxygenation