Comparison of Extracorporeal Membrane Oxygenation Initiation in Cardiogenic Shock During Work-Hours Versus After-Hours.

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2025-02-11 DOI:10.1111/aor.14952

Chenglong Li, Xiaomeng Wang, Zhongtao Du, Andong Lu, Liwen Lyv, Sheng Zhang, Jianling Liu, Yan Liu, Liuer Zuo, Yue Huang, Binfei Li, Ping Chang, Yi Yang, Jianhua Liu, Man Huang, Haixiu Xie, Liangshan Wang, Feng Yang, Hong Wang, Xiaotong Hou

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引用次数: 0

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) as rescue therapy for cardiogenic shock (CS) is highly dependent on timeliness and medical resources.

Objectives: Aimed to assess ECMO management and outcomes in adult patients with CS in terms of on- and after-hour ECMO initiation from a national ECMO registry.

Methods: Adult patients diagnosed with CS and those who received ECMO were enrolled in the study. The population was divided into the work-hours and the after-hours group based on the time of ECMO initiation. In-hospital mortality and ECMO management were compared between them. Electronic data in this research were provided by Chinese Society of Extracorporeal Life Support.

Results: In a cohort of 1862 patients, 552 (29.6%) received ECMO during work-hours, whereas 1310 (70.4%) received ECMO during after-hours. After-hour ECMO had more patients with elective cardiac procedures (35.1% vs. 26.3%, p < 0.001) and higher severity (p < 0.001), with more patients with Society for Cardiovascular Angiography and Interventions shock stage D (29.6% vs. 24.5), E (60.0% vs. 51.8%), and fewer B (3.6% vs. 13.2%) and C (6.8% vs. 10.5%). A high proportion underwent intra-aortic balloon pump (IABP) implantation before ECMO (28.4% vs. 23.0%, p = 0.016) and mechanical ventilation (92.1% vs. 87.0%, p < 0.001) during after-hours. The in-hospital mortality in patients with after-hour ECMO initiation was higher than that in patients with work-hour ECMO initiation (51.8% vs. 45.3%, p = 0.011).

Conclusion: In this cohort, 70% were initiated during after-hours and showed higher in-hospital mortality than patients with work-hour ECMO initiation. After-hour ECMO initiation should be a concern for ECMO programs.

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.