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

Ann Thorac Surg. 2021 Jan;111(1):327-369. doi: 10.1016/j.athoracsur.2020.07.009. Epub 2020 Oct 6.

Abstract

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.

Publication types

  • Consensus Development Conference
  • Practice Guideline

MeSH terms

  • 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

Substances

  • Anticoagulants