Trends, Predictors, and Outcomes of Temporary Mechanical Circulatory Support for Postcardiac Surgery Cardiogenic Shock

Complications in Patients with Acute Myocardial Infarction Supported with Extracorporeal Membrane Oxygenation

“…During the period between 1 January 2000 through 31 December 2016, a retrospective cohort of admissions from the HCUP-NIS with a primary diagnosis of AMI (International Classification of Disease-9 Clinical Modification [ICD-9CM] 410.x; International Classification of Disease-10 Clinical Modification [ICD-10CM] I21.x-22.x) receiving ECMO support (ICD-9CM 39.65; ICD-10CM 5A15223) were identified consistent with prior literature [7]. Deyo's modification of Charlson Comorbidity Index was used to identify co-morbid diseases and prior methodology was used to identify cardiac and non-cardiac procedures [2,3,7,8,11,[13][14][15][16][17][18][19][20][21][22][23]. We identified relevant complications and categorized them as (a) vascular complications-arterial injury, acquired arterio-venous fistula, and vascular complications requiring surgery; (b) lower limb amputation; (c) hematologic-post-operative hemorrhage, hemolytic anemia, thrombocytopenia, and blood transfusion; and (d) neurologic-ischemic or hemorrhagic stroke ( Supplementary Table S1).…”

“…In patients with AMI, ECMO is often used to support tenuous hemodynamics during cardiac arrest, cardiopulmonary resuscitation, cardiogenic shock, and high risk coronary intervention [1][2][3][4][5][6][7][8]. However, by virtue of its unique configuration, ECMO is associated with higher left ventricular afterload, greater vascular complications due to large bore access, limb ischemia due to lack of antegrade flow, greater clotting, and thrombocytopenia due to a complex circuit and higher risk of strokes due to variation in anticoagulation [1].…”

“…Extracorporeal membrane oxygenation (ECMO) is increasingly used in acute cardiovascular care for the management of acute myocardial infarction (AMI) complicated by cardiac arrest, cardiogenic shock and complications from cardiac interventional procedures [1][2][3][4][5][6][7][8][9][10]. ECMO provides cardiac output support of nearly 3-5 L, biventricular support and respiratory support, thereby assisting with critical cardiorespiratory support in extreme situations [11].…”

“…ECMO provides cardiac output support of nearly 3-5 L, biventricular support and respiratory support, thereby assisting with critical cardiorespiratory support in extreme situations [11]. Despite limited data and the absence of randomized controlled trials, ECMO has been widely accepted in clinical practice [2][3][4][5][6][7][8]. Despite the stated benefits from ECMO therapy, these acutely ill patients receiving ECMO support for AMI continue to experience high in-hospital mortality [7].…”

Influence of seasons on the management and outcomes acute myocardial infarction: An 18‐year US study

“…The Deyo's modification of the Charlson Comorbidity Index was used to identify the burden of comorbid diseases (Table S1). 15 Demographic characteristics, hospital characteristics, acute organ failure, mechanical circulatory support, cardiac procedures, and noncardiac organ support use were identified for all admissions using previously used methodologies from our group 16‐47 . The four geographic regions included the Northeast, Midwest, South, and West as classified by the HCUP‐NIS 35 .…”