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.