Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock

Federico Pappalardo; Christian Schulte; Marina Pieri; Benedikt Schrage; Rachele Contri; Gerold Soeffker; Teresa Greco; Rosalba Lembo; Kai Müllerleile; Antonio Colombo; Michele De Bonis; Karsten Sydow; Florian Wagner; Hermann Reichenspurner; Stefan Blankenberg; Alberto Zangrillo; Dirk Westermann

doi:10.1002/ejhf.668

Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock

Standard

Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. / Pappalardo, Federico; Schulte, Christian; Pieri, Marina; Schrage, Benedikt; Contri, Rachele; Soeffker, Gerold; Greco, Teresa; Lembo, Rosalba; Müllerleile, Kai; Colombo, Antonio; De Bonis, Michele; Sydow, Karsten; Wagner, Florian ; Reichenspurner, Hermann ; Blankenberg, Stefan; Zangrillo, Alberto; Westermann, Dirk.

In: EUR J HEART FAIL, Vol. 19, No. 3, 03.2017, p. 404-412.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Pappalardo, F, Schulte, C, Pieri, M, Schrage, B, Contri, R, Soeffker, G, Greco, T, Lembo, R, Müllerleile, K, Colombo, A, De Bonis, M, Sydow, K, Wagner, F , Reichenspurner, H , Blankenberg, S, Zangrillo, A & Westermann, D 2017, 'Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock', EUR J HEART FAIL, vol. 19, no. 3, pp. 404-412. https://doi.org/10.1002/ejhf.668

APA

Pappalardo, F., Schulte, C., Pieri, M., Schrage, B., Contri, R., Soeffker, G., Greco, T., Lembo, R., Müllerleile, K., Colombo, A., De Bonis, M., Sydow, K., Wagner, F., Reichenspurner, H., Blankenberg, S., Zangrillo, A., & Westermann, D. (2017). Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. EUR J HEART FAIL, 19(3), 404-412. https://doi.org/10.1002/ejhf.668

Vancouver

Pappalardo F, Schulte C, Pieri M, Schrage B, Contri R, Soeffker G et al. Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock. EUR J HEART FAIL. 2017 Mar;19(3):404-412. https://doi.org/10.1002/ejhf.668

Bibtex

@article{4c20bb60eb8c4b0f9a90cc24ffd3cba6,

title = "Concomitant implantation of Impella({\textregistered}) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock",

abstract = "AIMS: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support stabilizes patients with cardiogenic shock. Despite improved oxygenation and peripheral circulation, LV unloading may be impeded due to the increased afterload, resulting in a failing static left ventricle and in high mortality.METHODS AND RESULTS: We describe for the first time a large series of patients treated with the combination of VA-ECMO and Impella({\textregistered}) compared with patients with VA-ECMO only. We retrospectively collected data on patients from two tertiary critical care referral centres. We enrolled 157 patients treated with VA-ECMO from January 2013 to April 2015: 123 received VA-ECMO support and 34 had concomitant treatment with VA-ECMO and Impella. A propensity-matching analysis was performed in a 2:1 ratio, resulting in 42 patients undergoing VA-ECMO alone (control group) compared with 21 patients treated with VA-ECMO and Impella. Patients in the VA-ECMO and Impella group had a significantly lower hospital mortality (47% vs. 80%, P < 0.001) and a higher rate of successful bridging to either recovery or further therapy (68% vs. 28%, P < 0.001) compared with VA-ECMO patients. A higher need for continuous veno-venous haemofiltration (48% vs. 19%, P = 0.02) and increased haemolysis (76% vs. 33%, P = 0.004) were reported in the study group due to higher survival. There was no difference in major bleeding rates between the two groups (VA-ECMO and Impella 38% vs. VA-ECMO 29%, P = 0.6).CONCLUSIONS: Concomitant treatment with VA-ECMO and Impella may improve outcome in patients with cardiogenic shock compared with VA-ECMO only. Nevertheless, randomized studies are needed to validate these promising results further.",

author = "Federico Pappalardo and Christian Schulte and Marina Pieri and Benedikt Schrage and Rachele Contri and Gerold Soeffker and Teresa Greco and Rosalba Lembo and Kai M{\"u}llerleile and Antonio Colombo and {De Bonis}, Michele and Karsten Sydow and Florian Wagner and Hermann Reichenspurner and Stefan Blankenberg and Alberto Zangrillo and Dirk Westermann",

note = "{\textcopyright} 2016 The Authors. European Journal of Heart Failure {\textcopyright} 2016 European Society of Cardiology.",

year = "2017",

month = mar,

doi = "10.1002/ejhf.668",

language = "English",

volume = "19",

pages = "404--412",

journal = "EUR J HEART FAIL",

issn = "1388-9842",

publisher = "Oxford University Press",

number = "3",

}

RIS

TY - JOUR

T1 - Concomitant implantation of Impella(®) on top of veno-arterial extracorporeal membrane oxygenation may improve survival of patients with cardiogenic shock

AU - Pappalardo, Federico

AU - Schulte, Christian

AU - Pieri, Marina

AU - Schrage, Benedikt

AU - Contri, Rachele

AU - Soeffker, Gerold

AU - Greco, Teresa

AU - Lembo, Rosalba

AU - Müllerleile, Kai

AU - Colombo, Antonio

AU - De Bonis, Michele

AU - Sydow, Karsten

AU - Wagner, Florian

AU - Reichenspurner, Hermann

AU - Blankenberg, Stefan

AU - Zangrillo, Alberto

AU - Westermann, Dirk

PY - 2017/3

Y1 - 2017/3

N2 - AIMS: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support stabilizes patients with cardiogenic shock. Despite improved oxygenation and peripheral circulation, LV unloading may be impeded due to the increased afterload, resulting in a failing static left ventricle and in high mortality.METHODS AND RESULTS: We describe for the first time a large series of patients treated with the combination of VA-ECMO and Impella(®) compared with patients with VA-ECMO only. We retrospectively collected data on patients from two tertiary critical care referral centres. We enrolled 157 patients treated with VA-ECMO from January 2013 to April 2015: 123 received VA-ECMO support and 34 had concomitant treatment with VA-ECMO and Impella. A propensity-matching analysis was performed in a 2:1 ratio, resulting in 42 patients undergoing VA-ECMO alone (control group) compared with 21 patients treated with VA-ECMO and Impella. Patients in the VA-ECMO and Impella group had a significantly lower hospital mortality (47% vs. 80%, P < 0.001) and a higher rate of successful bridging to either recovery or further therapy (68% vs. 28%, P < 0.001) compared with VA-ECMO patients. A higher need for continuous veno-venous haemofiltration (48% vs. 19%, P = 0.02) and increased haemolysis (76% vs. 33%, P = 0.004) were reported in the study group due to higher survival. There was no difference in major bleeding rates between the two groups (VA-ECMO and Impella 38% vs. VA-ECMO 29%, P = 0.6).CONCLUSIONS: Concomitant treatment with VA-ECMO and Impella may improve outcome in patients with cardiogenic shock compared with VA-ECMO only. Nevertheless, randomized studies are needed to validate these promising results further.

AB - AIMS: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support stabilizes patients with cardiogenic shock. Despite improved oxygenation and peripheral circulation, LV unloading may be impeded due to the increased afterload, resulting in a failing static left ventricle and in high mortality.METHODS AND RESULTS: We describe for the first time a large series of patients treated with the combination of VA-ECMO and Impella(®) compared with patients with VA-ECMO only. We retrospectively collected data on patients from two tertiary critical care referral centres. We enrolled 157 patients treated with VA-ECMO from January 2013 to April 2015: 123 received VA-ECMO support and 34 had concomitant treatment with VA-ECMO and Impella. A propensity-matching analysis was performed in a 2:1 ratio, resulting in 42 patients undergoing VA-ECMO alone (control group) compared with 21 patients treated with VA-ECMO and Impella. Patients in the VA-ECMO and Impella group had a significantly lower hospital mortality (47% vs. 80%, P < 0.001) and a higher rate of successful bridging to either recovery or further therapy (68% vs. 28%, P < 0.001) compared with VA-ECMO patients. A higher need for continuous veno-venous haemofiltration (48% vs. 19%, P = 0.02) and increased haemolysis (76% vs. 33%, P = 0.004) were reported in the study group due to higher survival. There was no difference in major bleeding rates between the two groups (VA-ECMO and Impella 38% vs. VA-ECMO 29%, P = 0.6).CONCLUSIONS: Concomitant treatment with VA-ECMO and Impella may improve outcome in patients with cardiogenic shock compared with VA-ECMO only. Nevertheless, randomized studies are needed to validate these promising results further.

U2 - 10.1002/ejhf.668

DO - 10.1002/ejhf.668

M3 - SCORING: Journal article

C2 - 27709750

VL - 19

SP - 404

EP - 412

JO - EUR J HEART FAIL

JF - EUR J HEART FAIL

SN - 1388-9842

IS - 3

ER -