Extracorporeal life support in XXXX : Impact of acute versus chronic etiology on outcome.

@entity1 @entity712 @entity296 @entity63 @entity384 @entity583 @entity1455
BACKGROUND: The role of extracorporeal life support (ECLS) in primary @entity1455 (PCS) is well established. In this study, we evaluated the impact of etiology on outcomes. METHODS: Between January 2009 and March 2013, we implanted a total of 249 @entity1 with ECLS; we focused on 64 @entity1 for whom peripheral ECLS was the treatment for PCS. Of these, 37 cases (58%) were "acute" (mostly acute @entity583 : 39%); 27 (42%) had an exacerbation of "chronic" @entity712 ( @entity384 : 30%; post- @entity63 @entity296 : 9%; and congenital: 3%). RESULTS: In the group with chronic etiology, 23 @entity1 were bridged to a left ventricular assist device (52%) or heart transplantation (33%). In the group with acute etiology, ECLS was used as a bridge-to-transplantation in 3 @entity1 (8%), a bridge-to-bridge in 9 (24%), and a bridge-to-recovery in 18 (49%). One @entity1 in each group was bridged to conventional surgery. Recovery of cardiac function was achieved in only the group with acute primary @entity1455 (18 vs 0 @entity1 , P  =  .0001). A mean flow during support of  <=60% of the theoretic flow (body surface area  *  2.4) was a predictor of successful weaning (P  =  .02). Median duration of ECLS support was 7 days (range: 2-11.5 days). Nine @entity1 (14%) died during support; 30-day overall survival was 80% (51  of 64 @entity1 ); and 59% of @entity1 were discharged, in whom survival at 48 months was 90%. Thirty-day survival was correlated with duration of ECLS support. CONCLUSIONS: In "chronic" @entity712 , ECLS represents a bridge to a ventricular assist device or heart transplantation, whereas in "acute" settings, it offers a considerable chance of recovery, and is often the only required therapy.
