2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients

• Published in: The Annals of thoracic surgery Vol. 111; no. 1; pp. 327 - 369
• Main Authors: Lorusso, Roberto, Whitman, Glenn, Milojevic, Milan, Raffa, Giuseppe, McMullan, David M., Boeken, Udo, Haft, Jonathan, Bermudez, Christian A., Shah, Ashish S., D’Alessandro, David A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2021
• Subjects: Adult; Advanced Cardiac Life Support - standards; Anticoagulants - therapeutic use; Cardiac Surgical Procedures; Contraindications, Procedure; Critical Care - standards; Extracorporeal Membrane Oxygenation - standards; Humans; Intensive Care Units; Postoperative Care - standards; Prognosis; Prostheses and Implants; Treatment Outcome; ECPR; PCS; RVAD; RCT; IABP; RV; ECLS; ST-MCS; CO2; Oxy-RVAD; LV; V-A; EACTS; LVAD; STS; RRT; SAVE; MI; LT-MCS; ARDS; V-V; ECMO; aPTT; ELSO; CO; PGD; HTx; PA; ACT; HIT; AT; PC; CPB; LCO; DTIs; ICU; CABG; MCS
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2020.07.009

Post-cardiotomy extracorporeal life support (PC-ECLS) in adult patients has been used only rarely but recent data have shown a remarkable increase in its use, almost certainly due to improved technology, ease of management, growing familiarity with its capability and decreased costs. Trends in worldwide in-hospital survival, however, rather than improving, have shown a decline in some experiences, likely due to increased use in more complex, critically ill patients rather than to suboptimal management. Nevertheless, PC-ECLS is proving to be a valuable resource for temporary cardiocirculatory and respiratory support in patients who would otherwise most likely die. Because a comprehensive review of PC-ECLS might be of use for the practitioner, and possibly improve patient management in this setting, the authors have attempted to create a concise, comprehensive and relevant analysis of all aspects related to PC-ECLS, with a particular emphasis on indications, technique, management and avoidance of complications, appraisal of new approaches and ethics, education and training.