Extracorporeal membrane oxygenation (ECMO) in the management of non-surgical patients with cardiogenic shock and cardiac arrest

Results The major indication for circulatory support therapy was cardiogenic shock, followed by refractory cardiac arrest, arrhythmic storm, and support of high-risk interventions. Median duration of circulatory support was 3 days, maximum 62 days. The all-cause 30-day mortality in our group was 34.5%; in the subgroup of patients with severe refractory cardiogenic shock the 30-day mortality was 49.4%. In patients with refractory cardiac arrest, where ECMO was introduced during continuous chest compressions, 4 individuals from 18 treated survived with good neurological outcome. We found significant survival differences between subgroup with urgent circulatory support introduction and patients with semi-urgent support (30-day mortality 44.1% vs. 5.3%, P < 0.001). We observed significantly higher lactate levels prior to ECMO insertion in survivors in comparison with non-survivors (P < 0.05); other baseline characteristics including age or left-ventricle ejection fraction were comparable. We evaluated also the role of cerebral/ peripheral near-infrared spectroscopy (NIRS) oximetry in the non-invasive monitoring of global circulatory status in patients with mini-invasive circulatory support.