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Is it possible to predict outcome in cardiac ECMO? Analysis of preoperative risk factors

Department of Anaesthesiology, Rikshospitalet-Radiumhospitalet Medical Centre N-0027 Oslo, Norway, kari.wagner{at}rikshospitalet.no

Ivar Risnes

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Centre N-0027 Oslo, Norway

Michael Abdelnoor

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Centre N-0027 Oslo, Norway

Harald M. Karlsen

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Centre N-0027 Oslo, Norway

Jan Ludvig Svennevig

Department of Thoracic and Cardiovascular Surgery, Rikshospitalet-Radiumhospitalet Medical Centre N-0027 Oslo, Norway, University of Oslo, Norway

Background. Serious heart failure may be treated with extracorporeal membrane oxygenation (ECMO) when other treatment fails. The aim of the present study was to analyse preoperative risk factors of early mortality in patients treated with veno-arterial (VA)-ECMO. Methods. We studied a total of 18 possible risk factors in 80 patients with severe cardiac insufficiency treated with VA-ECMO. All consecutive cases treated at our institution between Sept.1990 and May 2006 were included. Univariate analysis and multiple logistic regression analysis were performed on 16 risk factors. The endpoint was early mortality (any death within 30 days of ECMO treatment). Results. Thirty patients (37.5%) died within 30 days. Age, gender, cause of cardiac failure, pre-ECMO treatment (ventilator, NO, IABP) did not significantly influence early mortality. A higher SvO₂ was associated with survival and remained significant in the multivariate analysis. Conclusion. Treatment with VA-ECMO in patients with severe cardiac failure may save lives. It is, however, difficult to predict outcome. In this study, only SvO₂ values prior to ECMO were positively associated with survival. Perfusion (2007) 22, 225—229.

Perfusion, Vol. 22, No. 4, 225-229 (2007)
DOI: 10.1177/0267659107083241


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