{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:23:11Z","timestamp":1777638191497,"version":"3.51.4"},"reference-count":17,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Post-cardiotomy cardiogenic shock (PCCS) remains a life-threatening complication after cardiac surgery. Extracorporeal membrane oxygenation (ECMO) represents the mainstay of mechanical circulatory support for PCCS; however, its availability is limited to larger experienced centers, leading to a mismatch between centers performing cardiac surgery and hospitals offering ECMO management beyond cannulation. We sought to evaluate the outcomes and complications of PCCS patients requiring veno-arterial (V-A) ECMO cannulated at our hospital compared to those cannulated at referral hospitals. Methods: A retrospective analysis of PCCS patients requiring V-A ECMO was conducted between October 2014 to December 2022. Results: A total of 121 PCCS patients required V-A ECMO support, of which 62 (51%) patients were cannulated at the referring institutions and retrieved (retrieved group), and 59 (49%) were cannulated at our hospital (on-site group). The baseline demographics and pre-ECMO variables were similar between groups, except retrieved patients had higher lactic acid levels (retrieved group: 8.5 mmol\/L \u00b1 5.8 vs. on-site group: 6.6 \u00b1 5; p = 0.04). Coronary artery bypass graft was the most common surgical intervention (51% in the retrieved group vs. 47% in the on-site group). There was no difference in survival-to-discharge rates between the groups (45% in the retrieved group vs. 51% in the on-site group; p = 0.53) or in the rate of patient-related complications. Conclusions: PCCS patients retrieved on V-A ECMO can achieve similar outcomes as those cannulated at experienced centers. An established network in a hub-and-spoke model is critical for the PCCS patients managed at hospitals without ECMO abilities to improve outcomes.<\/jats:p>","DOI":"10.3390\/jcm13113265","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T11:43:48Z","timestamp":1717155828000},"page":"3265","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing Outcomes of Post-Cardiotomy Cardiogenic Shock Patients: On-Site Cannulation vs. Retrieval for V-A ECMO Support"],"prefix":"10.3390","volume":"13","author":[{"given":"Mircea R.","family":"Mihu","sequence":"first","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"},{"name":"Department of Medicine, Oklahoma State University Health Science Center, Tulsa, OK 74077, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-2322","authenticated-orcid":false,"given":"Ahmed M.","family":"El Banayosy","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Harper","sequence":"additional","affiliation":[{"name":"Department of Surgical Critical Care, MedStar Washington Hospital Center, Washington, DC 20010, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlyn","family":"Cain","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2406-655X","authenticated-orcid":false,"given":"Marc O.","family":"Maybauer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Critical Care Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Philipps University, 35043 Marburg, Germany"},{"name":"Critical Care Research Group, The Prince Charles Hospital, The University of Queensland, Brisbane, QLD 4072, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura V.","family":"Swant","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9323-0547","authenticated-orcid":false,"given":"Joseph M.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0880-6861","authenticated-orcid":false,"given":"Robert S.","family":"Schoaps","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammar","family":"Sharif","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clayne","family":"Benson","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Freno","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Integris Heart Hospital, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marshall T.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Integris Heart Hospital, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Chaffin","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Integris Heart Hospital, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles C.","family":"Elkins","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Integris Heart Hospital, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Vanhooser","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoracic Surgery, Integris Heart Hospital, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aly","family":"El Banayosy","sequence":"additional","affiliation":[{"name":"Specialty Critical Care, Advanced Cardiac Care and Acute Circulatory Support, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, OK 73112, USA"},{"name":"Department of Medicine, Oklahoma State University Health Science Center, Tulsa, OK 74077, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.healun.2019.08.014","article-title":"Structured review of post-cardiotomy extracorporeal membrane oxygenation: Part 1-Adult patients","volume":"38","author":"Lorusso","year":"2019","journal-title":"J. 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