Introduction
Extra-corporeal membrane oxygenation (ECMO) therapy has been growing in
use over the last several decades. In 1990, there were 1,644 ECMO runs
performed at 83 centers, which has increased to 10,423 cases among 391
centers in 2018[1]. Much of this growth has been
due to an increase in the number of ECMO runs performed on adult cardiac
patients [1]. According to the 2018
Extra-Corporeal Life Support Organization (ELSO) registry data, 59% of
all adult cardiac patients were able to be successfully weaned from
extra-corporeal life support, with 42% of these patients surviving to
hospital discharge[1].
Post-Cardiotomy ECMO (PC-ECMO) represents a unique subset of critically
ill patients following cardiac surgery. One of the feared complications
following open heart surgery is refractory post-cardiotomy cardiogenic
shock (PCS), which occurs in between 0.5-1.5% of adult cardiac surgical
patients [2-3]. There is a paucity of data
regarding long-term survival of PC-ECMO patients, and even less
regarding which patient characteristics are correlated with better short
and long-term survival in this cohort. Survival to hospital discharge,
which has been the most frequently reported outcome, has varied
significantly. Early studies demonstrated rates of hospital-survival of
25-30%[3-4], with more recent data showing 50%
of patients may be successfully weaned from ECMO and short-term (6
months or less) survival ranging from
37%-42%[5-6]. The few studies that have reported
longer-term survival have shown overall 2-year survival to be around
37%[6] for PC-ECMO patients.
Given the relative lack of data related to long-term survival in
PC-ECMO, we present a retrospective cohort series of post-cardiotomy
patients supported with ECMO at our institution.