TABLE 2.
Characteristics of Extracorporeal Membrane Oxygenation (ECMO) Placement and Duration of Support in Adult Patients Undergoing Post-Cardiotomy ECMO
| Author reference – Year of Publication | ECMO Implantation Location, % | Time: Surgery-to-ECMO Implant | ECMO Cannulation, % | IABP, % | Left Ventricular Venting, % | Limb Perfusion, % | ECMO Duration, means ± SD (range) |
|---|---|---|---|---|---|---|---|
| Magovern14 - 1994 | OR 54.5 ICU 45.5 |
1–48 hours | Central 76.2 Peripheral 23.8 | 100 | 0 | na | 42.1 hours (19–92 hours) |
| Kodera15 - 1996 | na | Weaned patients 2.85±1.8hrs Unweaned patients 15.8±7.5hrs |
Central and Peripheral | 100 | 100 | na | 11.3±6.0 / 31.0±12.8a hours |
| Fiser16 - 2001 | OR 43.1 ICU 56.8 |
na | Central and Peripheral | na | na | na | 85±12.5 / 64.7±9.2 hours |
| Smedira17 - 2001 | na | na | Central 33 Peripheral 67 | na | na | nab | 48 – 72 hours |
| Ko18 - 2002 | OR 51.3 ICU 48.7 |
na | Central 19.7 Peripheral 80.3 (open 56.4 - percutaneous 21.7) |
69 | 2.6 | 26.3 of femoral cannulation cases | 99±33 hours |
| Zhang19 - 2006 | na | na | Central 40.6 Peripheral 53.1 Subcl. Art.-Fem. Vein 6.3 |
31.2 | na | na | 2.7 ± 1.7 days |
| Bakhtiary20 - 2007 | OR 67 ICU 33 |
24–48 hours (in 6 patients) |
Central 18 Peripheral 64 Subcl. Art.-Fem. Vein 18 |
67 | 0 | nac | 6.4 ± 4.5 days |
| Hsu21 - 2010 | na | na | Central 0 Peripheral 100 |
100 | na | 100d | 7.5 ± 6.7 days |
| Rastan22 - 2010 | OR 41.9 ICU 58.1 |
62.6 hours (in 58.1% of the patients) |
Central 60.8 Peripheral 39.2 | 74.1 | na | 23.4 of femoral cannulation cases | 78.7 ± 68.4 hours |
| Elsharkawy23 – 2010 | OR and ICU | na | Central 33 Peripheral 67 | na | na | na | na |
| Pokersnik24 - 2012 | na | na | Central 35 Peripheral 65 | 59.2 | na | 60 | 3.1 (±2.1)e / 4.1 (±3.7)f / 4.3 (±3.0)g days |
| Mikus25 - 2013 | OR 85.7 ICU 14.3 |
48 hours | Central 57.1 Peripheral 42.9 |
100 | 100h | 100 | 5 days (1–55 days) |
| Slottosch26 - 2013 | OR 44.2 ICU 55.8 |
45±69 hours | Peripheral 100 (open) | 93.5 | 0 | 91 | 79 ± 57 hours |
| Unosawa27 - 2013 | OR 70.2 ICU 29.8 |
na | Central and Peripheral | 83 | 0 | 100i | 63.5 ± 61.5 hours |
| Ariyaratnam28 - 2014 | na | na | Central 100 Peripheral 0 |
na | na | na | 1 – 14 days |
| Li29 - 2015 | OR 49.6 ICU 50.4 |
na | Central 0 Peripheral 100 (open) |
59.3 | na | na | 4.4 ± 3.7 days |
| Saxena30 – 2015j | OR 57.8 ICU 42.2 |
na | Central 66 Peripheral 34 | na | na | na | 103 ±74.3 hours |
| Khorsandi31 - 2016 | na | na | Central 67 Peripheral 33 | na | na | na | > 1 – 33 days |
| Distelmaier32 - 2016k | OR 86 ICU 14 |
na | Aorta-Femoral 10 Subcl-Fem 38 Peripheral 52 |
12 | na | na | 96 hours |
| Mazzeffi33 - 2016 b | OR and ICU | 31 (15–52) min. | Central 60.9 Peripheral 39.1 | 13 | 0 | na | 0 – 14 days |
| Chen34 - 2017 | na | na | na | na | na | na | |
| Guihaire35 - 2017 | OR 86.9 ICU 13.1 |
48 hours | Central 14.7 Peripheral 85.3 |
27.1 | 14.1 | na | 6 days (1–28 days) |
| Raffa36 - 2017 | OR 55.8 ICU 44.2 |
na | Central 17.4 Peripheral 65.1 Central (artery) – Peripheral (vein) 17.4 |
27.1 | na | na | 5 days |
| Fux37 – 2018 | OR 49 | na | Peripheral 76 Central 24 |
na | na | 90% | 7 days (median) (1–55) |
CPB, cardiopulmonary bypass; ECMO, extracorporeal membrane oxygenation; ECPR, extracorporeal cardiopulmonary resuscitation; IABP, intra-aortic balloon pump; ICU, intensive care unit; na, not available; OR, operating room; RVF, right ventricular failure; Subcl-Fem, subclavian artery
Groups related to patients who were weaned and discharged versus patients weaned from ECMO but not discharged and died in hospital
Performed in all patients with femoral cannulation in the most recent series, after an initial experience without it characterized by ischemia episodes of the cannulated limb
Distal limb perfusion performed but no data available
Distal limb perfusion achieved by cannulating the femoral artery with a 8 mm-graft perfusing antegradely and retrogradely
Group of patients receiving Biomedicus (Medtronic Inc, Minneapolis, Minn) pump and Affinity oxygenator (Medtronic Inc. Minneapolis, Minn)
Group of patients receiving Biomedicus (Medtronic Inc, Minneapolis, Minn) and Quadrox D (Getinge, Hirrlingen, Germany) oxygenator
Group of patients receiving Rotaflow (Getinge, Hirrlingen, Germany) pump and Quadrox D (Getinge, Hirrlingen, Germany) oxygenator
Venting was performed in all patients who had central cannulation and no patients with femoral cannulation
Distal limb perfusion was performed in 100% of cases after 1999
Study included only patients over 70 years of age
Study included only extracorporeal cardiopulmonary resuscitation (ECPR) after cardiac surgery