{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:06:38Z","timestamp":1785575198031,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T00:00:00Z","timestamp":1568592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Cardiac Surgery"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with acute myocardial infarction (AMI) are at high risk when undergoing emergency coronary artery bypass graft (CABG)\u2010surgery. Their outcome remains poor despite increased use of extracorporeal membrane oxygenation (ECMO). We investigated the impact of timing for perioperative ECMO\u2010support in these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective double\u2010center study, we evaluated 201 patients with AMI undergoing CABG, dividing them into the following groups: No\u2010ECMO (n\u2009=\u2009101), preoperative ECMO (pre\u2010ECMO, n\u2009=\u20096), intraoperative ECMO (ECC\u2010ECMO, n\u2009=\u200967), and postoperative ECMO (post\u2010ECMO, n\u2009=\u200927). We evaluated the impact of ECMO timing on postoperative mortality, organ function, and length of stay, comparing these to predicted outcome using different risk\u2010scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Post\u2010ECMO patients showed lowest 30\u2010day\u2010survival (40.7%), while earlier ECMO\u2010start was associated with better outcome (50.7% in extracorporeal circulation [ECC]\u2010ECMO and 66.7% in pre\u2010ECMO patients). On admission, only pre\u2010ECMO and ECC\u2010ECMO patients showed higher surgery\u2010 and intensive\u2010care\u2010unit (ICU)\u2010related risk\u2010scores. In pre\u2010 and ECC\u2010ECMO patients, the first significant increase in lactate\u2010levels (&gt;4\u2009mmol\/L) was observed preoperatively, while this occurred 1 hour postoperatively in post\u2010ECMO patients. Bilirubin was increased in all patients, decreasing after 3 and 12 days in pre\u2010 and ECC\u2010ECMO patients, respectively, but only after 18 days in post\u2010ECMO patients. Multiple ICU risk\u2010scores did not discriminate survival\u2010probability correctly. Only the ECMO\u2010related survival after veno\u2010arterial\u2010ECMO\u2010score correctly predicted the significantly lower survival in post\u2010ECMO patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study shows that timely ECMO\u2010support is associated with earlier bilirubin\u2010downtrend and higher survival in patients with AMI after CABG. Lactate\u2010increase greater than 4\u2009mmol\/L seems to be a helpful threshold to trigger the timely onset of ECMO\u2010therapy, providing better survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocs.14258","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T04:00:16Z","timestamp":1568606416000},"page":"1243-1255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Timely extracorporeal membrane oxygenation assist reduces mortality after bypass surgery in patients with acute myocardial infarction"],"prefix":"10.1155","volume":"34","author":[{"given":"Marwan","family":"Hamiko","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery University Clinical Centre Bonn 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