{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:40:13Z","timestamp":1793605213250,"version":"4.5.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>A survival gap between weaning from venoarterial-extracorporeal membrane oxygenation (VA-ECMO) and the hospital discharge has been consistently reported. The aim of this study is to investigate the clinical features of patients who underwent successful VA-ECMO decannulation at our institution and to identify the major contributors responsible for adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed all patients supported with VA-ECMO in our institution between January 2013 and June 2020. Only patients that survived VA-ECMO and underwent successful decannulation were included and dichotomized based on survival to hospital discharge: non-survivors versus survivors. The primary study outcome was the cause of death after successful VA-ECMO decannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 262 adult patients who underwent VA-ECMO decannulation, 72 (27.5%) patients did not survive to hospital discharge. Non-survivors were older (62 vs. 54 years, p\u2009&lt;\u20090.001) and suffering from many pre-existing comorbidities. Pneumonia and sepsis were the most frequent infectious complication and almost twice as likely in non-survivors. Major causes of death were: cardiovascular (31.9%), infections (25.0%) and neurological (20.8%). The survival curve demonstrated that 51.4% of our patients died within 8 days after decannulation. Multivariate analysis identified older age, central venous cannulation, pulmonary bleeding and infection, dialysis after VA-ECMO, sepsis, and ischemic stroke (OR\u2009=\u20097.86, 95% CI: 2.76-2.43, p\u2009&lt;\u20090.001) as factors significantly predisposing to patients\u2019 death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our study, one-third of patients decannulated off VA-ECMO did not survive to hospital discharge due to end-stage heart failure, infections or neurological injury. The first 8 post-decannulation days were recognized as a critical period where thorough strategies to prevent acquired infections and cautious support of end-organ function should be warranted. Future large-scale trials are needed to confirm our results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666221086839","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T09:00:45Z","timestamp":1647248445000},"page":"1545-1552","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Cause of In-Hospital Death After Weaning from Venoarterial-Extracorporeal Membrane Oxygenation"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0468-8511","authenticated-orcid":false,"given":"Milica","family":"Bjelic","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0198-0077","authenticated-orcid":false,"given":"Neil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6984-3653","authenticated-orcid":false,"given":"Yang","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Chase","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frane","family":"Paic","sequence":"additional","affiliation":[{"name":"Department of Medical Biology and Genetics, University of Zagreb Medical School, Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Gosev","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"bibr1-08850666221086839","unstructured":"Extracorporeal Life Support Registry Report \u2013 International Summary 2020. 2021.Available at: https:\/\/www.elso.org\/Registry\/Statistics\/InternationalSummary.aspx"},{"key":"bibr2-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv194"},{"key":"bibr3-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2020.01.009"},{"key":"bibr4-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001809"},{"key":"bibr5-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1007\/s10047-021-01252-w"},{"key":"bibr6-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2020.07.069"},{"key":"bibr7-08850666221086839","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.13097"},{"key":"bibr8-08850666221086839","first-page":"3505784","volume":"2017","author":"Lee W","year":"2017","journal-title":"Biomed Res Int"},{"key":"bibr9-08850666221086839","author":"Cooper DS","year":"2020","journal-title":"J Intensive Care 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