{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T10:44:51Z","timestamp":1786272291754,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T00:00:00Z","timestamp":1421366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T00:00:00Z","timestamp":1421366400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2015,5]]},"abstract":"Abstract<\/jats:title>\n \n Severe acute heart failure requires immediate intensive care unit (\n ICU<\/jats:styled-content>\n ) treatment, but prognosis and outcome of further treatment regimens largely depends on the preprocedural status of the patient. Especially, multiorgan failure including mechanical ventilation are unfavorable predictors of clinical outcome. Here, we report a strategy of immediate initiation of extracorporeal life support (\n ECLS<\/jats:styled-content>\n ) in awake and spontaneously breathing patients with acute heart failure to achieve early multiorgan recovery and gain sufficient time for further treatment planning. Twenty\u2010three patients with severe cardiac failure refractory to standard medical management underwent\n ECLS<\/jats:styled-content>\n treatment, after first clinical signs of cardiac failure appeared to avoid mechanical ventilation. Hemodynamic parameters and renal and liver functions were monitored. Outcome at 1 and 6 months was determined. Patients 46.1\u2009\u00b1\u200915.5 years of age were placed on\n ECLS<\/jats:styled-content>\n due to various underlying diagnosis: ischemic heart disease (\n n<\/jats:italic>\n \u2009=\u20096), dilatative cardiomyopathy (\n n<\/jats:italic>\n \u2009=\u20094), myocarditis (\n n<\/jats:italic>\n \u2009=\u20092), graft failure following heart transplantation (\n n<\/jats:italic>\n \u2009=\u20096), or other diseases (\n n<\/jats:italic>\n \u2009=\u20095).\n ECLS<\/jats:styled-content>\n lasted 11.9\u2009\u00b1\u200912.9 days. Hemodynamic stabilization was achieved immediately after\n ECLS<\/jats:styled-content>\n initiation. Vasopressors were reduced subsequently and the cardiac situation improved indicated by central venous saturation, which increased from 38.5\u2009\u00b1\u200911.3% before to 74.26\u2009\u00b1\u20098.4% (\n P<\/jats:italic>\n \u2009<\u20090.0001) 24\u2009h after\n ECLS<\/jats:styled-content>\n initiation. Similarly, serum lactate levels decreased from 4.7\u2009\u00b1\u20094.6 to 1.7\u2009\u00b1\u20091.51\u2009mmol\/L (\n P<\/jats:italic>\n \u2009=\u20090.003). Cumulative 30\u2010day survival was 87.5%, and 6\u2010month survival was 70.8%. In acute cardiac failure, early\n ECLS<\/jats:styled-content>\n treatment is a safe, feasible treatment in awake patients allowing a gain of time for final decision. Moreover, this strategy avoids complications associated with sedation and mechanical ventilation and leads to recovery of secondary organ function, enabling destination therapy.\n <\/jats:p>","DOI":"10.1111\/aor.12396","type":"journal-article","created":{"date-parts":[[2015,1,16]],"date-time":"2015-01-16T10:43:16Z","timestamp":1421404996000},"page":"400-408","source":"Crossref","is-referenced-by-count":17,"title":["Cardiac Awake Extracorporeal Life Support\u2014Bridge to Decision?"],"prefix":"10.1111","volume":"39","author":[{"given":"Wiebke","family":"Sommer","sequence":"first","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Marsch","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Kaufeld","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"R\u00f6ntgen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gernot","family":"Beutel","sequence":"additional","affiliation":[{"name":"Department of Haematology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joern","family":"Tongers","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Warnecke","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Tudorache","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Schieffer","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Haverich","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Transplant and Cardiovascular Surgery Hannover Medical School Hannover 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