Current applications and outcomes of venoarterial extracorporeal membrane oxygenation based on six years of experience. Risk factors for in-hospital mortality. A single-center retrospective study

Abstract

VA ECMO for circulatory support: risk factors for hospital mortality 1 and outcome are insufficient. Therefore, accord ing to the European Society of Cardiology guide lines, its use could be considered (class IIb recom mendation) with the lowest possible level of evi dence (C). 1 The need for more robust data is even more apparent for the Central and Eastern Euro pean population, as most evidence for guidance in the ECMO therapy originates from population based studies performed in Western European INTROduCTION Venoarterial extracorporeal membrane oxygenation (VA ECMO) is an appli cable treatment option in the setting of refracto ry cardiogenic shock (CS), a condition related to soaring rates of mortality. The trend to use VA ECMO as acute cardiopulmonary life support is progressing worldwide. However, due to the re markably challenging clinical scenarios, the avail able data regarding its applicability, complications,

Arterial Hyperoxia and Mortality in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation

“…Numerous retrospective studies and meta-analyses implied that oxygen might be overused in critical care, strongly suggesting that the subsequent hyperoxemia, similarly to hypoxemia, might be related to increased in-hospital mortality (2,5,6,19). Based on these preceding data, two large randomized trials focused on the conservative versus liberal oxygen use in mechanically ventilated patients were conducted recently (20,21).…”

“…Ninety-day and 1-year mortality refer strictly to time intervals after ECMO implantation, during the index hospitalization, or after being discharged. A detailed summary of the population studied has already been described elsewhere (2).…”

“…As data imply, ECMO may be associated with improved survival in this group, as opposed to the nearly inevitable fatal outcome if left untreated. Extracorporeal membrane oxygenation provides powerful cardiocirculatory support, giving time for cardiac recovery or bridging the critically ill patient to other forms of mechanical circulatory support or heart transplantation (1,2). As a result of ECMO, disturbances in oxygenation are corrected, and organ perfusion is sustained.…”