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Clinical Outcomes of Early Extubation Strategy in Patients Undergoing Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation

Taeho Youn, Darae Kim, Taek Kyu Park, Yang Hyun Cho, Su Hyun Cho, Ji Yeon Choi, Kiick Sung, Jin‐Oh Choi, Eun‐Seok Jeon, Jeong Hoon Yang

2020Journal of Korean Medical Science14 citationsDOIOpen Access PDF

Abstract

BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) might be considered a bridge therapy in patients who are expected to have short waiting times for heart transplantation. We investigated the clinical outcomes of patients who underwent VA-ECMO as a bridge to heart transplantation and whether the deployment of an early extubation ECMO strategy is beneficial. METHODS: Between November 2006 and December 2018, we studied 102 patients who received VA-ECMO as a bridge to heart transplantation. We classified these patients into an early extubation ECMO group (n = 24) and a deferred extubation ECMO group (n = 78) based on the length of the intubated period on VA-ECMO (≤ 48 hours or > 48 hours). The primary outcome was in-hospital mortality. RESULTS: = 0.051), respectively. CONCLUSION: VA-ECMO as a bridge therapy seems to be feasible for deployment in patients with a short waiting time for heart transplantation. Deployment of the early extubation ECMO strategy was associated with reductions in delirium and infection in this population.

Topics & Concepts

Extracorporeal membrane oxygenationMedicineHeart transplantationBridge to transplantationOxygenationTransplantationBridge (graph theory)SurgeryCardiologyIntensive care medicineAnesthesiaMechanical Circulatory Support DevicesTransplantation: Methods and OutcomesComplement system in diseases