Maryna Masyuk1, Peter Abel2, Martin Hug3, Bernhard Wernly4, Assad Haneya5, Stefan Sack6, Konstantinos Sideris7, Nicolas Langwieser8, Tobias Graf9, Georg Fuernau9, Marcus Franz10, Ralf Westenfeld1, Malte Kelm1,11, Stephan B Felix2,12, Christian Jung13. 1. Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany. 2. Division of Cardiology, Pneumology and Critical Care Medicine, Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany. 3. Department of Cardiology, Pulmonology and Internal Intensive Care Medicine, Städtisches Klinikum München GmbH, Klinikum Neuperlach, Munich, Germany. 4. Department of Cardiology, Paracelsus Medical University, Salzburg, Austria. 5. Department of Cardiovascular Surgery, University of Schleswig, Holstein Campus Kiel, Kiel, Germany. 6. Department of Cardiology, Pneumology, and Internal Intensive Care Medicine, Schwabing Hospital, Academic Municipal Hospital Munich, Munich, Germany. 7. Department of Cardiovascular Surgery, German Heart Center, Technische Universität München (TUM), Munich, Germany. 8. Medical Clinic I, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. 9. Department of Cardiology, Angiology, Intensive Care Medicine, Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany. 10. Department of Cardiology, Clinic of Internal Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany. 11. CARID: Cardiovascular Research Institute Düsseldorf, Düsseldorf, Germany. 12. DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany. 13. Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany. christian.jung@med.uni-duesseldorf.de.
Abstract
BACKGROUND: The concept of percutaneous extracorporeal life support (ECLS) is based on immediate cardiovascular stabilization allowing for sufficient end-organ perfusion, thus improving the outcome in patients with circulatory arrest. Lifebridge® (Zoll Medical GmbH, Germany) is a portable ECLS device designed for rapid application due to its automated set-up. METHODS: A total of 60 tertiary cardiovascular centers were interrogated with regard to application and short-term results after use of Lifebridge ECLS system. Detailed data were collected by standardized case report forms in all centers consented to participate in the study. Demographic and clinical baseline characteristics of the patient population, procedural and follow-up data were recorded and analyzed. RESULTS: In total, 444 patients were analyzed regarding mortality. The detailed study cohort consisted of 112 patients. A total of 80% of the study subjects represented patients post cardiopulmonary resuscitation, 43% were in cardiogenic shock and 50% suffered from acute myocardial infarction. The survival rates were 36% immediately after device implementation and 16% after 30 days. Multivariable analysis revealed that only serum lactate concentration at admission could be proven as independent predictor of patients' outcome. Patients with lactate concentrations above 10 mmol/L exhibited > 95% mortality (p < 0.05 versus below 10 mmol/L). CONCLUSION: The present study provides real-world clinical data of patients treated with a transportable automated ECLS system. In conclusion, Lifebridge is a safely applicable cardiorespiratory stabilization tool associated with acceptable complication rates. Nevertheless, mortality rates were high in these critically ill patients, especially in those showing high lactate concentrations at admission.
BACKGROUND: The concept of percutaneous extracorporeal life support (ECLS) is based on immediate cardiovascular stabilization allowing for sufficient end-organ perfusion, thus improving the outcome in patients with circulatory arrest. Lifebridge® (Zoll Medical GmbH, Germany) is a portable ECLS device designed for rapid application due to its automated set-up. METHODS: A total of 60 tertiary cardiovascular centers were interrogated with regard to application and short-term results after use of Lifebridge ECLS system. Detailed data were collected by standardized case report forms in all centers consented to participate in the study. Demographic and clinical baseline characteristics of the patient population, procedural and follow-up data were recorded and analyzed. RESULTS: In total, 444 patients were analyzed regarding mortality. The detailed study cohort consisted of 112 patients. A total of 80% of the study subjects represented patients post cardiopulmonary resuscitation, 43% were in cardiogenic shock and 50% suffered from acute myocardial infarction. The survival rates were 36% immediately after device implementation and 16% after 30 days. Multivariable analysis revealed that only serum lactate concentration at admission could be proven as independent predictor of patients' outcome. Patients with lactate concentrations above 10 mmol/L exhibited > 95% mortality (p < 0.05 versus below 10 mmol/L). CONCLUSION: The present study provides real-world clinical data of patients treated with a transportable automated ECLS system. In conclusion, Lifebridge is a safely applicable cardiorespiratory stabilization tool associated with acceptable complication rates. Nevertheless, mortality rates were high in these critically ill patients, especially in those showing high lactate concentrations at admission.
Entities:
Keywords:
Cardiac arrest; Cardiogenic shock; ECLS; Extracorporeal life support; Mechanical circulatory support
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