{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:38:53Z","timestamp":1787020733843,"version":"build-2736575974"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiogenic shock and cardiac arrest are life-threatening emergencies with high mortality rates. Veno-arterial extracorporeal membrane oxygenation (VA ECMO) and extracorporeal cardiopulmonary resuscitation (e-CPR) provide viable options for life sustaining measures when medical therapy fails. The purpose of this study is to determine the utilization and outcomes of VA ECMO and eCPR in patients that require emergent cardiac support at a single academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review of prospectively collected data was performed at an academic institution from January 1st, 2018 to June 30th, 2020. All consecutive patients who required VA ECMO were evaluated based on whether they underwent traditional VA ECMO or eCPR. The study variables include demographic data, duration on ECMO, length of stay, complications, and survival to discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 90 patients were placed on VA ECMO for cardiac support with 44.4% (40) of these patients undergoing eCPR secondary to cardiac arrest and emergent placement on ECMO. A majority of the patients were male (n\u2009=\u200964, 71.1%) and the mean age was 58.8\u2009\u00b1\u200915.8\u00a0years. 44.4% of patients were transferred from outside hospitals for a higher level of care and 37.8% of patients required another primary therapy such as an Impella or IABP. The most common complication experienced by patients was bleeding (n\u2009=\u200941, 45.6%), which occurred less often in eCPR (n\u2009=\u200929, 58% vs. n\u2009=\u200912, 30%). Other complications included infections (n\u2009=\u200911, 12.2%), limb ischemia (n\u2009=\u200913, 14.4%), acute kidney injury (n\u2009=\u200917, 18.9%), and cerebral vascular accident (n\u2009=\u20094, 4.4%). The length of stay was longer for patients on VA ECMO (32.1\u2009\u00b1\u200940.7\u00a0days vs. 17.7\u2009\u00b1\u200918.2\u00a0days). Mean time on ECMO was 8.1\u2009\u00b1\u20098.3\u00a0days. Survival to discharge was higher in VA ECMO patients (n\u2009=\u200923, 46% vs. n\u2009=\u20098, 20%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VA ECMO provided an effective rescue therapy in patients in acute cardiogenic shock with a survival greater than the expected ELSO guidelines of 40%. While the survival of eCPR was lower than expected, this may reflect the severity of patient\u2019s condition and emphasizes the importance of careful patient selection and planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-021-01674-w","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T16:26:06Z","timestamp":1633883166000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Short-term and intermediate outcomes of cardiogenic shock and cardiac arrest patients supported by venoarterial extracorporeal membrane oxygenation"],"prefix":"10.1186","volume":"16","author":[{"given":"Deep","family":"Vakil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Soto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoee","family":"D\u2019Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Volk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivaveera","family":"Kandasamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepa","family":"Iyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohisa","family":"Ikegami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard Y.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8936-9853","authenticated-orcid":false,"given":"Anthony","family":"Lemaire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"issue":"16","key":"1674_CR1","doi-asserted-by":"publisher","first-page":"e232","DOI":"10.1161\/CIR.0000000000000525","volume":"136","author":"S van Diepen","year":"2017","unstructured":"van Diepen S, Katz JN, Albert NM, et al. Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association. Circulation. 2017;136(16):e232\u201368. https:\/\/doi.org\/10.1161\/CIR.0000000000000525.","journal-title":"Circulation"},{"issue":"1","key":"1674_CR2","doi-asserted-by":"publisher","first-page":"e000590","DOI":"10.1161\/JAHA.113.000590","volume":"3","author":"D Kolte","year":"2014","unstructured":"Kolte D, Khera S, Aronow WS, et al. Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States. J Am Heart Assoc. 2014;3(1):e000590. https:\/\/doi.org\/10.1161\/JAHA.113.000590.","journal-title":"J Am Heart Assoc"},{"issue":"6","key":"1674_CR3","doi-asserted-by":"publisher","first-page":"e003704","DOI":"10.1161\/JAHA.116.003704","volume":"5","author":"LK Kim","year":"2016","unstructured":"Kim LK, Looser P, Swaminathan RV, et al. Sex-based disparities in incidence, treatment, and outcomes of cardiac arrest in the United States, 2003\u20132012. J Am Heart Assoc. 2016;5(6):e003704. https:\/\/doi.org\/10.1161\/JAHA.116.003704.","journal-title":"J Am Heart Assoc"},{"issue":"5","key":"1674_CR4","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1097\/CCM.0b013e31816f7cf7","volume":"36","author":"A Combes","year":"2008","unstructured":"Combes A, Leprince P, Luyt CE, et al. Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med. 2008;36(5):1404\u201311. https:\/\/doi.org\/10.1097\/CCM.0b013e31816f7cf7.","journal-title":"Crit Care Med"},{"issue":"1","key":"1674_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/CCM.0b013e3181feb339","volume":"39","author":"TG Shin","year":"2011","unstructured":"Shin TG, Choi JH, Jo IJ, et al. Extracorporeal cardiopulmonary resuscitation in patients with inhospital cardiac arrest: a comparison with conventional cardiopulmonary resuscitation. Crit Care Med. 2011;39(1):1\u20137. https:\/\/doi.org\/10.1097\/CCM.0b013e3181feb339.","journal-title":"Crit Care Med"},{"issue":"9638","key":"1674_CR6","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/S0140-6736(08)60958-7","volume":"372","author":"YS Chen","year":"2008","unstructured":"Chen YS, Lin JW, Yu HY, et al. Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet. 2008;372(9638):554\u201361. https:\/\/doi.org\/10.1016\/S0140-6736(08)60958-7.","journal-title":"Lancet"},{"issue":"2","key":"1674_CR7","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jtcvs.2009.10.043","volume":"139","author":"AJ Rastan","year":"2010","unstructured":"Rastan AJ, Dege A, Mohr M, et al. Early and late outcomes of 517 consecutive adult patients treated with extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock. J Thorac Cardiovasc Surg. 2010;139(2):302-311.e1. https:\/\/doi.org\/10.1016\/j.jtcvs.2009.10.043.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"1674_CR8","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/j.jtcvs.2013.09.033","volume":"148","author":"BG Maxwell","year":"2014","unstructured":"Maxwell BG, Powers AJ, Sheikh AY, Lee PH, Lobato RL, Wong JK. Resource use trends in extracorporeal membrane oxygenation in adults: an analysis of the nationwide inpatient sample 1998\u20132009. J Thorac Cardiovasc Surg. 2014;148(2):416-21.e1. https:\/\/doi.org\/10.1016\/j.jtcvs.2013.09.033.","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"1674_CR9","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1053\/j.semtcvs.2015.07.005","volume":"27","author":"FH McCarthy","year":"2015","unstructured":"McCarthy FH, McDermott KM, Kini V, et al. Trends in U.S. extracorporeal membrane oxygenation use and outcomes: 2002\u20132012. Semin Thorac Cardiovasc Surg. 2015;27(2):81\u20138. https:\/\/doi.org\/10.1053\/j.semtcvs.2015.07.005.","journal-title":"Semin Thorac Cardiovasc Surg"},{"issue":"2","key":"1674_CR10","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1177\/0267659114530455","volume":"30","author":"AS Sharma","year":"2015","unstructured":"Sharma AS, Weerwind PW, Ganushchak YM, Donker DW, Maessen JG. Towards a proactive therapy utilizing the modern spectrum of extracorporeal life support: a single-centre experience. Perfusion. 2015;30(2):113\u20138. https:\/\/doi.org\/10.1177\/0267659114530455.","journal-title":"Perfusion"},{"issue":"4","key":"1674_CR11","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1053\/j.jvca.2018.08.193","volume":"33","author":"M Kaushal","year":"2019","unstructured":"Kaushal M, Schwartz J, Gupta N, et al. Patient demographics and extracorporeal membranous oxygenation (ECMO)-related complications associated with survival to discharge or 30-day survival in adult patients receiving venoarterial (VA) and venovenous (VV) ECMO in a quaternary care urban center. J Cardiothorac Vasc Anesth. 2019;33(4):910\u20137. https:\/\/doi.org\/10.1053\/j.jvca.2018.08.193.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"10","key":"1674_CR12","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1016\/j.amjcard.2015.08.030","volume":"116","author":"BJ Carroll","year":"2015","unstructured":"Carroll BJ, Shah RV, Murthy V, et al. Clinical features and outcomes in adults with cardiogenic shock supported by extracorporeal membrane oxygenation. Am J Cardiol. 2015;116(10):1624\u201330. https:\/\/doi.org\/10.1016\/j.amjcard.2015.08.030.","journal-title":"Am J Cardiol"},{"issue":"6","key":"1674_CR13","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1053\/j.jvca.2010.03.020","volume":"24","author":"HA Elsharkawy","year":"2010","unstructured":"Elsharkawy HA, Li L, Esa WA, Sessler DI, Bashour CA. Outcome in patients who require venoarterial extracorporeal membrane oxygenation support after cardiac surgery. J Cardiothorac Vasc Anesth. 2010;24(6):946\u201351. https:\/\/doi.org\/10.1053\/j.jvca.2010.03.020.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"4","key":"1674_CR14","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1097\/MAT.0000000000000225","volume":"61","author":"L Truby","year":"2015","unstructured":"Truby L, Mundy L, Kalesan B, et al. Contemporary outcomes of venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock at a large tertiary care center. ASAIO J. 2015;61(4):403\u20139. https:\/\/doi.org\/10.1097\/MAT.0000000000000225.","journal-title":"ASAIO J"},{"issue":"1","key":"1674_CR15","doi-asserted-by":"publisher","first-page":"66","DOI":"10.21037\/acs.2018.12.09","volume":"8","author":"MM Koerner","year":"2019","unstructured":"Koerner MM, Harper MD, Gordon CK, et al. Adult cardiac veno-arterial extracorporeal life support (VA-ECMO): prevention and management of acute complications. Ann Cardiothorac Surg. 2019;8(1):66\u201375. https:\/\/doi.org\/10.21037\/acs.2018.12.09.","journal-title":"Ann Cardiothorac Surg"},{"issue":"3 Suppl","key":"1674_CR16","doi-asserted-by":"publisher","first-page":"S60","DOI":"10.1016\/s0003-4975(00)02626-6","volume":"71","author":"NG Smedira","year":"2001","unstructured":"Smedira NG, Blackstone EH. Postcardiotomy mechanical support: risk factors and outcomes. Ann Thorac Surg. 2001;71(3 Suppl):S60\u201385. https:\/\/doi.org\/10.1016\/s0003-4975(00)02626-6.","journal-title":"Ann Thorac Surg"},{"issue":"6","key":"1674_CR17","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1016\/j.athoracsur.2014.11.075","volume":"99","author":"P Saxena","year":"2015","unstructured":"Saxena P, Neal J, Joyce LD, et al. Extracorporeal membrane oxygenation support in postcardiotomy elderly patients: The Mayo Clinic experience. Ann Thorac Surg. 2015;99(6):2053\u201360. https:\/\/doi.org\/10.1016\/j.athoracsur.2014.11.075.","journal-title":"Ann Thorac Surg"},{"issue":"2","key":"1674_CR18","doi-asserted-by":"publisher","first-page":"e0013","DOI":"10.5041\/RMMJ.10363","volume":"10","author":"M Makhoul","year":"2019","unstructured":"Makhoul M, Bitton-Worms K, Adler Z, Saeed A, Cohen O, Bolotin G. Extracorporeal Membrane Oxygenation (ECMO)\u2014a lifesaving technology. Review and single-center experience. Rambam Maimonides Med J. 2019;10(2):e0013. https:\/\/doi.org\/10.5041\/RMMJ.10363.","journal-title":"Rambam Maimonides Med J."},{"key":"1674_CR19","unstructured":"Extracorporeal Life Support Organization\u2014ECMO and ECLS > Registry > Statistics > International Summary. 2020. https:\/\/www.elso.org\/Registry\/Statistics\/InternationalSummary.aspx. Accessed 3 Nov 2020."},{"issue":"1","key":"1674_CR20","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s13054-017-1633-1","volume":"21","author":"M Smith","year":"2017","unstructured":"Smith M, Vukomanovic A, Brodie D, Thiagarajan R, Rycus P, Buscher H. Duration of veno-arterial extracorporeal life support (VA ECMO) and outcome: an analysis of the Extracorporeal Life Support Organization (ELSO) registry. Crit Care. 2017;21(1):45. https:\/\/doi.org\/10.1186\/s13054-017-1633-1.","journal-title":"Crit Care"},{"issue":"1","key":"1674_CR21","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13019-017-0618-0","volume":"12","author":"M Khorsandi","year":"2017","unstructured":"Khorsandi M, Dougherty S, Bouamra O, et al. Extra-corporeal membrane oxygenation for refractory cardiogenic shock after adult cardiac surgery: a systematic review and meta-analysis. J Cardiothorac Surg. 2017;12(1):55. https:\/\/doi.org\/10.1186\/s13019-017-0618-0.","journal-title":"J Cardiothorac Surg"},{"issue":"2","key":"1674_CR22","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1111\/j.1525-1594.2003.47255.x","volume":"28","author":"T Murashita","year":"2004","unstructured":"Murashita T, Eya K, Miyatake T, et al. Outcome of the perioperative use of percutaneous cardiopulmonary support for adult cardiac surgery: factors affecting hospital mortality. Artif Organs. 2004;28(2):189\u201395. https:\/\/doi.org\/10.1111\/j.1525-1594.2003.47255.x.","journal-title":"Artif Organs"},{"issue":"2","key":"1674_CR23","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.athoracsur.2013.09.008","volume":"97","author":"R Cheng","year":"2014","unstructured":"Cheng R, Hachamovitch R, Kittleson M, et al. Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1866 adult patients. Ann Thorac Surg. 2014;97(2):610\u20136. https:\/\/doi.org\/10.1016\/j.athoracsur.2013.09.008.","journal-title":"Ann Thorac Surg"},{"issue":"4","key":"1674_CR24","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1053\/j.jvca.2018.06.003","volume":"33","author":"AA Dalia","year":"2019","unstructured":"Dalia AA, Ortoleva J, Fiedler A, Villavicencio M, Shelton K, Cudemus GD. Extracorporeal Membrane Oxygenation is a team sport: institutional survival benefits of a formalized ECMO team. J Cardiothorac Vasc Anesth. 2019;33(4):902\u20137. https:\/\/doi.org\/10.1053\/j.jvca.2018.06.003.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"3","key":"1674_CR25","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/s00134-016-4223","volume":"42","author":"G Muller","year":"2016","unstructured":"Muller G, Flecher E, Lebreton G, et al. The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock. Intensive Care Med. 2016;42(3):370\u20138. https:\/\/doi.org\/10.1007\/s00134-016-4223.","journal-title":"Intensive Care Med"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01674-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-021-01674-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-021-01674-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T16:39:53Z","timestamp":1633883993000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-021-01674-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,9]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1674"],"URL":"https:\/\/doi.org\/10.1186\/s13019-021-01674-w","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,9]]},"assertion":[{"value":"29 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Obtained by each author.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"290"}}