Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598756
Oral Presentations
Sunday, February 12, 2017
DGTHG: ECC and Myocardial Protection
Georg Thieme Verlag KG Stuttgart · New York

Extracorporeal Membrane Oxygenation (ECMO) Support to Patients Aged 70 Years or More after Cardiac Surgery

H. Welp
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
,
A. Dell'Aquila
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
,
S. Martens
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
,
J. Sindermann
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
,
M. Scherer
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
,
H. Deschka
1   Department für Herz- und Thoraxchirurgie; Klinik für Herzchirurgie, Universitätsklinikum Münster, Münster, Germany
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Publikationsverlauf

Publikationsdatum:
03. Februar 2017 (online)

Background: The indication for extracorporeal membrane oxygenation (ECMO) therapy in elderly patients is still controversial. We conducted this study to assess outcomes of elderly patients who required ECMO support for postcardiotomy cardiogenic shock.

Methods: In the period from 2001 to 2016, 176 patients aged ≥ 70 years underwent open-heart surgery in our department and suffered from postoperative cardiogenic shock, consequently treated with ECMO. Medical records of these patients were retrospectively analyzed to investigate postoperative morbidity and mortality of these patients.

Results: Mean age of the study collective 74.8 ± 3.46 years. 62.5% (110 pat.) of the patients were male. 63.1% (111 pat.) of the patients required intraoperative veno-arterial ECMO support due to the impossibility of separation from cardiopulmonary bypass. 36.9% (65 pat.) received delayed ECMO support within 48 hours (28.1 ± 5.37 hours) postoperatively. Mean duration of ECMO therapy was 185.7 ± 91.3 hours. 53.4% of the patients (94 pat.) could be weaned from ECMO support and 24.5% (46 pat.) of the study cohort was discharged alive from hospital. The most frequent complications during ECMO support were acute kidney injury (51.1%), pneumonia (46.2%), and sepsis (17.1%), chronic kidney injury, lactic acidosis on ECMO support, and age over 80 years were independent risk factors for adverse outcome/impaired survival.

Conclusion: Postcardiotomy ECMO support in elderly patients is associated with excess morbidity and mortality. But given the fact that ECMO therapy represents the last line of therapy for these critically ill patients, this treatment option should be considered also for selected elderly patients.