Extracorporeal membrane oxygenation for refractory cardiogenic shock after aortic surgery: risk factors of in-hospital mortality

Abstract

Objective To evaluate risk factors of in-hospital mortality during extracorporeal membrane oxygenation(ECMO) support for those with refractory cardiogenic shock after aortic surgery. Methods Retrospective analyses were conducted for 35 patients using ECMO after aortic surgery at Beijing Anzhen Hospital, Capital Medical University from September 2009 to March 2016. Demographic characteristics, diagnosis, ECMO related data, including ECMO indication, operation, clinical parameters before and 24 hours during ECMO were collected to set up a database. The patients were divided into survival group and non-survival group according to the prognosis. The risk factors of mortality in hospital after ECMO were analyzed by multivariate logistic regression analysis regression. Results There were 35 adult patients who had received ECMO support with 32 male and 3female. All patients received veno-arterial ECMO(V-A ECMO). ECMO was successfully weaned in 22 patients(62.9%), and 18 patients(51.4%) survived.Multivariate logistic regression analysis revealed that high lactic acid levels at 12 hours after ECMO(OR=1.445; 95%CI: 1.026-2.034)and multiple organ dysfunction syndrome(MODS, OR=10.412; 95%CI: 2.246-70.798)(P<0.05) were independent risk factors of in-hospital mortality in adult patients undergoing ECMO after aortic surgery. Conclusion High lactic acid levels at 12 hours after ECMO and MODS were very important factors of patients undergoing ECMO after aortic surgery.The proper identification and management shall improve the prognosis of patients. Key words: Extracorporeal membrane oxygenation; Risk factor; Hospital mortality