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    Post Cardiotomy Extra Corporeal Membrane Oxygenation: Australian Cohort Review.

    Access Status
    Fulltext not available
    Authors
    Farag, James
    Summerhayes, Robyn
    Shen, Rong
    Bailey, Michael
    Williams-Spence, Jenni
    Reid, Christopher
    Marasco, Silvana F
    Date
    2020
    Type
    Journal Article
    
    Metadata
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    Citation
    Farag, J. and Summerhayes, R. and Shen, R. and Bailey, M. and Williams-Spence, J. and Reid, C.M. and Marasco, S.F. 2020. Post Cardiotomy Extra Corporeal Membrane Oxygenation: Australian Cohort Review. Heart, Lung and Circulation.
    Source Title
    Heart, Lung and Circulation
    DOI
    10.1016/j.hlc.2020.05.092
    ISSN
    1443-9506
    Faculty
    Faculty of Health Sciences
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/80045
    Collection
    • Curtin Research Publications
    Abstract

    BACKGROUND: Over the last two decades, technological advancements in the delivery of extra corporeal membrane oxygenation (ECMO) have seen its use broaden and results improve. However, in the post cardiotomy ECMO patient group, survival remains very poor without significant improvements over the last two decades. Our study aims to report on the Australian experience, with the intention of providing background data for the formation of guidelines in the future. METHODS: Retrospective analysis of prospectively collected data from the Australian and New Zealand Society of Cardiothoracic Surgeons (ANZSCTS) Database was performed. The ANZSCTS database captures at least 60% of cardiac surgical data in Australia, annually. Data was collected on adult patients who received ECMO post cardiotomy from September 2016 to November 2017 inclusive. Transplant and primary cardiomyopathy patients were excluded. RESULTS: Of the 16,605 adult patients undergoing cardiac surgery in the 15-month period of the study, 87 patients required post cardiotomy ECMO (0.52%). The average age of the entire cohort was 56 years. Overall survival to discharge was 43.7% (n=38). Multivariable logistic regression analysis demonstrated that multiorgan failure (MOF), increasing age and longer cardiopulmonary bypass time were significant predictors of in hospital mortality. CONCLUSIONS: Post cardiotomy ECMO support is an uncommon condition. Survival in this study appears to be better than historical reports. Identification of poor prognostic indicators in this study may help inform the development of guidelines for the most appropriate use of this support modality.

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