Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis
Abstract Background Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is associated with a high rate of morbidity and mortality. Beside other therapeutic measures (e.g. intraaortic balloon pump (IABP)), extracorporeal life support is being increasingly used in this particular form of shock....
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12871-025-02898-2 |
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| author | Romana Maria Kienlein Ralf Felix Trauzeddel Nilufar Akbari Leonello Avalli Fausto Biancari Carlotta Sorini Dini Sabina Guenther Christian Hagl Matthias Heringlake Jochen Kruppa Timo Mäkikallio Raphael Martins Marc Pineton de Chambrun Ardawan Julian Rastan Antonio Rubino Floris van den Brink Michael Nordine Sascha Treskatsch |
| author_facet | Romana Maria Kienlein Ralf Felix Trauzeddel Nilufar Akbari Leonello Avalli Fausto Biancari Carlotta Sorini Dini Sabina Guenther Christian Hagl Matthias Heringlake Jochen Kruppa Timo Mäkikallio Raphael Martins Marc Pineton de Chambrun Ardawan Julian Rastan Antonio Rubino Floris van den Brink Michael Nordine Sascha Treskatsch |
| author_sort | Romana Maria Kienlein |
| collection | DOAJ |
| description | Abstract Background Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is associated with a high rate of morbidity and mortality. Beside other therapeutic measures (e.g. intraaortic balloon pump (IABP)), extracorporeal life support is being increasingly used in this particular form of shock. Objectives of this meta-analysis were to determine mortality and complications of extracorporeal life support treatment (ECLS) in cardiac surgery patients, and if outcomes were influenced by a preexisting cardiovascular risk profile. Methods MEDLINE and EMBASE were searched for studies in English, published between January 1st 2000 and January 16th 2023, reporting mortality and morbidity in patients aged ≥ 18 treated with ECLS for PCCS. Supplementary data were requested from the respective corresponding authors. Outcomes were weaning from extracorporeal life support, hospital survival and complications. Results Two thousand, seven hundred seventy-four papers were screened, of which 132 full text articles were assessed for suitability. 70 remaining studies were included for further evaluation and data analysis. Five studies could be included in the final analysis since the corresponding authors provided additional necessary information. Successful weaning from extracorporeal life support was accomplished in 52.8% (30.8%—57.4%) and 31.1% were discharged alive (mortality of 25.0 – 56.2% after weaning). 95.1% of all treated patients suffered from at least one complication. Diabetes mellitus and obesity seem to be independent risk factors for poor outcome. Conclusions Extracorporeal life support for PCCS is associated with a substantial mortality and complication rate. Diabetes mellitus and obesity seem to be independent risk factors. Therefore, until future work has elucidated which patients benefit at all, the risks of ECLS-treatment must be critically weighed up against a possible benefit. |
| format | Article |
| id | doaj-art-8235345015fd4af9b88349ddb67177d9 |
| institution | Kabale University |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj-art-8235345015fd4af9b88349ddb67177d92025-01-19T12:36:49ZengBMCBMC Anesthesiology1471-22532025-01-0125111210.1186/s12871-025-02898-2Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysisRomana Maria Kienlein0Ralf Felix Trauzeddel1Nilufar Akbari2Leonello Avalli3Fausto Biancari4Carlotta Sorini Dini5Sabina Guenther6Christian Hagl7Matthias Heringlake8Jochen Kruppa9Timo Mäkikallio10Raphael Martins11Marc Pineton de Chambrun12Ardawan Julian Rastan13Antonio Rubino14Floris van den Brink15Michael Nordine16Sascha Treskatsch17Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin FranklinCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin FranklinCharité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical EpidemiologyDepartment of Cardiovascular Surgery, Centro Cardiologico MonzinoDepartment of Cardiovascular Surgery, Centro Cardiologico Monzino IRCCSIntensive Cardiac Care Unit, Azienda Ospedaliero-Universitaria CareggiDepartment of Cardiac Surgery, University Hospital Munich, Ludwig-Maximilian-UniversityDepartment of Cardiac Surgery, University Hospital Munich, Ludwig-Maximilian-UniversityDepartment of Anesthesiology and Intensive Care Medicine, Heart- and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg HospitalHochschule Osnabrück, University of Applied SciencesDepartment of Medicine, South Karelia Central Hospital, University of Helsinki1CHU Rennes, Service de Cardiologie Et Maladies VasculairesSorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital La Pitié-Salpêtrière, Service de Médecine Intensive RéanimationDepartment of Cardiac and Thoracic Vascular Surgery, Marburg University HospitalDepartment of Anaesthesia and Intensive Care, Royal Papworth HospitalDepartment of Intensive Care, Leids Universitair Medisch CentrumDepartment of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital Frankfurt, Goethe UniversityCharité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin FranklinAbstract Background Postcardiotomy cardiogenic shock (PCCS) in cardiac surgery is associated with a high rate of morbidity and mortality. Beside other therapeutic measures (e.g. intraaortic balloon pump (IABP)), extracorporeal life support is being increasingly used in this particular form of shock. Objectives of this meta-analysis were to determine mortality and complications of extracorporeal life support treatment (ECLS) in cardiac surgery patients, and if outcomes were influenced by a preexisting cardiovascular risk profile. Methods MEDLINE and EMBASE were searched for studies in English, published between January 1st 2000 and January 16th 2023, reporting mortality and morbidity in patients aged ≥ 18 treated with ECLS for PCCS. Supplementary data were requested from the respective corresponding authors. Outcomes were weaning from extracorporeal life support, hospital survival and complications. Results Two thousand, seven hundred seventy-four papers were screened, of which 132 full text articles were assessed for suitability. 70 remaining studies were included for further evaluation and data analysis. Five studies could be included in the final analysis since the corresponding authors provided additional necessary information. Successful weaning from extracorporeal life support was accomplished in 52.8% (30.8%—57.4%) and 31.1% were discharged alive (mortality of 25.0 – 56.2% after weaning). 95.1% of all treated patients suffered from at least one complication. Diabetes mellitus and obesity seem to be independent risk factors for poor outcome. Conclusions Extracorporeal life support for PCCS is associated with a substantial mortality and complication rate. Diabetes mellitus and obesity seem to be independent risk factors. Therefore, until future work has elucidated which patients benefit at all, the risks of ECLS-treatment must be critically weighed up against a possible benefit.https://doi.org/10.1186/s12871-025-02898-2Postcardiotomy cardiogenic shockOutcomeExtracorporeal life supportVeno-arterial extracorporeal membrane oxygenationMeta-analysis |
| spellingShingle | Romana Maria Kienlein Ralf Felix Trauzeddel Nilufar Akbari Leonello Avalli Fausto Biancari Carlotta Sorini Dini Sabina Guenther Christian Hagl Matthias Heringlake Jochen Kruppa Timo Mäkikallio Raphael Martins Marc Pineton de Chambrun Ardawan Julian Rastan Antonio Rubino Floris van den Brink Michael Nordine Sascha Treskatsch Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis BMC Anesthesiology Postcardiotomy cardiogenic shock Outcome Extracorporeal life support Veno-arterial extracorporeal membrane oxygenation Meta-analysis |
| title | Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis |
| title_full | Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis |
| title_fullStr | Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis |
| title_full_unstemmed | Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis |
| title_short | Outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support – a systematic review and meta-analysis |
| title_sort | outcome and complications in postcardiotomy cardiogenic shock treated with extracorporeal life support a systematic review and meta analysis |
| topic | Postcardiotomy cardiogenic shock Outcome Extracorporeal life support Veno-arterial extracorporeal membrane oxygenation Meta-analysis |
| url | https://doi.org/10.1186/s12871-025-02898-2 |
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