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Erschienen in: Clinical Research in Cardiology 1/2020

26.04.2019 | Original Paper

Real-world clinical experience with the percutaneous extracorporeal life support system: Results from the German Lifebridge® Registry

verfasst von: Maryna Masyuk, Peter Abel, Martin Hug, Bernhard Wernly, Assad Haneya, Stefan Sack, Konstantinos Sideris, Nicolas Langwieser, Tobias Graf, Georg Fuernau, Marcus Franz, Ralf Westenfeld, Malte Kelm, Stephan B. Felix, Christian Jung

Erschienen in: Clinical Research in Cardiology | Ausgabe 1/2020

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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.
Literatur
2.
Zurück zum Zitat Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, Buller CE, Jacobs AK, Slater JN, Col J, McKinlay SM, LeJemtel TH (1999) Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 341:625–634. https://doi.org/10.1056/NEJM199908263410901 CrossRefPubMed Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, Buller CE, Jacobs AK, Slater JN, Col J, McKinlay SM, LeJemtel TH (1999) Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. N Engl J Med 341:625–634. https://​doi.​org/​10.​1056/​NEJM199908263410​901 CrossRefPubMed
4.
Zurück zum Zitat Prondzinsky R, Unverzagt S, Russ M, Lemm H, Swyter M, Wegener N, Buerke U, Raaz U, Ebelt H, Schlitt A, Heinroth K, Haerting J, Werdan K, Buerke M (2012) Hemodynamic effects of intra-aortic balloon counterpulsation in patients with acute myocardiale infarction complicated by cardiogenetic shock: the prospective, randomized IABP shock trial. Shock Inj Inflamm Sepsis Lab Clin Approaches 37:378–384. https://doi.org/10.1097/SHK.0b013e31824a67af CrossRef Prondzinsky R, Unverzagt S, Russ M, Lemm H, Swyter M, Wegener N, Buerke U, Raaz U, Ebelt H, Schlitt A, Heinroth K, Haerting J, Werdan K, Buerke M (2012) Hemodynamic effects of intra-aortic balloon counterpulsation in patients with acute myocardiale infarction complicated by cardiogenetic shock: the prospective, randomized IABP shock trial. Shock Inj Inflamm Sepsis Lab Clin Approaches 37:378–384. https://​doi.​org/​10.​1097/​SHK.​0b013e31824a67af​ CrossRef
5.
Zurück zum Zitat Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan J, Koch KT, de Winter RJ, Piek JJ, Tijssen JGP, Henriques JPS (2009) A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J 30:459–468. https://doi.org/10.1093/eurheartj/ehn602 CrossRefPubMed Sjauw KD, Engström AE, Vis MM, van der Schaaf RJ, Baan J, Koch KT, de Winter RJ, Piek JJ, Tijssen JGP, Henriques JPS (2009) A systematic review and meta-analysis of intra-aortic balloon pump therapy in ST-elevation myocardial infarction: should we change the guidelines? Eur Heart J 30:459–468. https://​doi.​org/​10.​1093/​eurheartj/​ehn602 CrossRefPubMed
6.
Zurück zum Zitat Thiele H, Zeymer U, Neumann F-J, Ferenc M, Olbrich H-G, Hausleiter J, de Waha A, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Lauer B, Böhm M, Ebelt H, Schneider S, Werdan K, Schuler G (2013) Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet 382:1638–1645. https://doi.org/10.1016/S0140-6736(13)61783-3 CrossRefPubMed Thiele H, Zeymer U, Neumann F-J, Ferenc M, Olbrich H-G, Hausleiter J, de Waha A, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Lauer B, Böhm M, Ebelt H, Schneider S, Werdan K, Schuler G (2013) Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial. Lancet 382:1638–1645. https://​doi.​org/​10.​1016/​S0140-6736(13)61783-3 CrossRefPubMed
7.
Zurück zum Zitat Thiele H, Zeymer U, Neumann F-J, Ferenc M, Olbrich H-G, Hausleiter J, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Fuhrmann J, Böhm M, Ebelt H, Schneider S, Schuler G, Werdan K (2012) Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 367:1287–1296. https://doi.org/10.1056/NEJMoa1208410 CrossRefPubMed Thiele H, Zeymer U, Neumann F-J, Ferenc M, Olbrich H-G, Hausleiter J, Richardt G, Hennersdorf M, Empen K, Fuernau G, Desch S, Eitel I, Hambrecht R, Fuhrmann J, Böhm M, Ebelt H, Schneider S, Schuler G, Werdan K (2012) Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med 367:1287–1296. https://​doi.​org/​10.​1056/​NEJMoa1208410 CrossRefPubMed
8.
Zurück zum Zitat Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio ALP, Crea F, Goudevenos JA, Halvorsen S, Hindricks G, Kastrati A, Lenzen MJ, Prescott E, Roffi M, Valgimigli M, Varenhorst C, Vranckx P, Widimský P (2018) 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 39:119–177. https://doi.org/10.1093/eurheartj/ehx393 CrossRef Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio ALP, Crea F, Goudevenos JA, Halvorsen S, Hindricks G, Kastrati A, Lenzen MJ, Prescott E, Roffi M, Valgimigli M, Varenhorst C, Vranckx P, Widimský P (2018) 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 39:119–177. https://​doi.​org/​10.​1093/​eurheartj/​ehx393 CrossRef
9.
Zurück zum Zitat Shah M, Patnaik S, Patel B, Ram P, Garg L, Agarwal M, Agrawal S, Arora S, Patel N, Wald J, Jorde UP (2018) Trends in mechanical circulatory support use and hospital mortality among patients with acute myocardial infarction and non-infarction related cardiogenic shock in the United States. Clin Res Cardiol 107:287–303. https://doi.org/10.1007/s00392-017-1182-2 CrossRefPubMed Shah M, Patnaik S, Patel B, Ram P, Garg L, Agarwal M, Agrawal S, Arora S, Patel N, Wald J, Jorde UP (2018) Trends in mechanical circulatory support use and hospital mortality among patients with acute myocardial infarction and non-infarction related cardiogenic shock in the United States. Clin Res Cardiol 107:287–303. https://​doi.​org/​10.​1007/​s00392-017-1182-2 CrossRefPubMed
10.
Zurück zum Zitat Backhaus T, Fach A, Schmucker J, Fiehn E, Garstka D, Stehmeier J, Hambrecht R, Wienbergen H (2018) Management and predictors of outcome in unselected patients with cardiogenic shock complicating acute ST-segment elevation myocardial infarction: results from the Bremen STEMI Registry. Clin Res Cardiol 107:371–379. https://doi.org/10.1007/s00392-017-1192-0 CrossRefPubMed Backhaus T, Fach A, Schmucker J, Fiehn E, Garstka D, Stehmeier J, Hambrecht R, Wienbergen H (2018) Management and predictors of outcome in unselected patients with cardiogenic shock complicating acute ST-segment elevation myocardial infarction: results from the Bremen STEMI Registry. Clin Res Cardiol 107:371–379. https://​doi.​org/​10.​1007/​s00392-017-1192-0 CrossRefPubMed
13.
Zurück zum Zitat Chen Y-S, Lin J-W, Yu H-Y, Ko W-J, Jerng J-S, Chang W-T, Chen W-J, Huang S-C, Chi N-H, Wang C-H, Chen L-C, Tsai P-R, Wang S-S, Hwang J-J, Lin F-Y (2008) Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 372:554–561. https://doi.org/10.1016/S0140-6736(08)60958-7 CrossRefPubMed Chen Y-S, Lin J-W, Yu H-Y, Ko W-J, Jerng J-S, Chang W-T, Chen W-J, Huang S-C, Chi N-H, Wang C-H, Chen L-C, Tsai P-R, Wang S-S, Hwang J-J, Lin F-Y (2008) Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 372:554–561. https://​doi.​org/​10.​1016/​S0140-6736(08)60958-7 CrossRefPubMed
15.
Zurück zum Zitat Jung C, Franz M, Figulla H-R, Sonntag S, Hug M, Mudra H, Bauerschmitt R, Kleber F-X, Feindt P, Mehlhorn U, Vahl C, Bruns H-J, Ferrari M (2015) Percutaneous extracorporeal life support in patients with circulatory failure: results of the German Lifebridge Registry. J Invasive Cardiol 27:93–97PubMed Jung C, Franz M, Figulla H-R, Sonntag S, Hug M, Mudra H, Bauerschmitt R, Kleber F-X, Feindt P, Mehlhorn U, Vahl C, Bruns H-J, Ferrari M (2015) Percutaneous extracorporeal life support in patients with circulatory failure: results of the German Lifebridge Registry. J Invasive Cardiol 27:93–97PubMed
22.
Zurück zum Zitat Dzavik V, Sleeper LA, Cocke TP, Moscucci M, Saucedo J, Hosat S, Jiang X, Slater J, LeJemtel T, Hochman JS (2003) Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: a report from the SHOCK Trial Registry. Eur Heart J 24:828–837CrossRef Dzavik V, Sleeper LA, Cocke TP, Moscucci M, Saucedo J, Hosat S, Jiang X, Slater J, LeJemtel T, Hochman JS (2003) Early revascularization is associated with improved survival in elderly patients with acute myocardial infarction complicated by cardiogenic shock: a report from the SHOCK Trial Registry. Eur Heart J 24:828–837CrossRef
25.
Zurück zum Zitat Vellinga NAR, Boerma EC, Koopmans M, Donati A, Dubin A, Shapiro NI, Pearse RM, van der Voort PHJ, Dondorp AM, Bafi T, Fries M, Akarsu-Ayazoglu T, Pranskunas A, Hollenberg S, Balestra G, van Iterson M, Sadaka F, Minto G, Aypar U, Hurtado FJ, Martinelli G, Payen D, van Haren F, Holley A, Gomez H, Mehta RL, Rodriguez AH, Ruiz C, Canales HS, Duranteau J, Spronk PE, Jhanji S, Hubble S, Chierego M, Jung C, Martin D, Sorbara C, Bakker J, Ince C (2017) Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis. Crit Care 21:255. https://doi.org/10.1186/s13054-017-1842-7 CrossRefPubMedPubMedCentral Vellinga NAR, Boerma EC, Koopmans M, Donati A, Dubin A, Shapiro NI, Pearse RM, van der Voort PHJ, Dondorp AM, Bafi T, Fries M, Akarsu-Ayazoglu T, Pranskunas A, Hollenberg S, Balestra G, van Iterson M, Sadaka F, Minto G, Aypar U, Hurtado FJ, Martinelli G, Payen D, van Haren F, Holley A, Gomez H, Mehta RL, Rodriguez AH, Ruiz C, Canales HS, Duranteau J, Spronk PE, Jhanji S, Hubble S, Chierego M, Jung C, Martin D, Sorbara C, Bakker J, Ince C (2017) Mildly elevated lactate levels are associated with microcirculatory flow abnormalities and increased mortality: a microSOAP post hoc analysis. Crit Care 21:255. https://​doi.​org/​10.​1186/​s13054-017-1842-7 CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat O’Neill WW, Kleiman NS, Moses J, Henriques JPS, Dixon S, Massaro J, Palacios I, Maini B, Mulukutla S, Dzavík V, Popma J, Douglas PS, Ohman M (2012) A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 126:1717–1727. https://doi.org/10.1161/CIRCULATIONAHA.112.098194 CrossRefPubMed O’Neill WW, Kleiman NS, Moses J, Henriques JPS, Dixon S, Massaro J, Palacios I, Maini B, Mulukutla S, Dzavík V, Popma J, Douglas PS, Ohman M (2012) A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation 126:1717–1727. https://​doi.​org/​10.​1161/​CIRCULATIONAHA.​112.​098194 CrossRefPubMed
32.
34.
Zurück zum Zitat Schrage B, Burkhoff D, Rübsamen N, Becher PM, Schwarzl M, Bernhardt A, Grahn H, Lubos E, Söffker G, Clemmensen P, Reichenspurner H, Blankenberg S, Westermann D (2018) Unloading of the left ventricle during venoarterial extracorporeal membrane oxygenation therapy in cardiogenic shock. JACC Heart Fail 6:1035–1043. https://doi.org/10.1016/j.jchf.2018.09.009 CrossRefPubMed Schrage B, Burkhoff D, Rübsamen N, Becher PM, Schwarzl M, Bernhardt A, Grahn H, Lubos E, Söffker G, Clemmensen P, Reichenspurner H, Blankenberg S, Westermann D (2018) Unloading of the left ventricle during venoarterial extracorporeal membrane oxygenation therapy in cardiogenic shock. JACC Heart Fail 6:1035–1043. https://​doi.​org/​10.​1016/​j.​jchf.​2018.​09.​009 CrossRefPubMed
Metadaten
Titel
Real-world clinical experience with the percutaneous extracorporeal life support system: Results from the German Lifebridge® Registry
verfasst von
Maryna Masyuk
Peter Abel
Martin Hug
Bernhard Wernly
Assad Haneya
Stefan Sack
Konstantinos Sideris
Nicolas Langwieser
Tobias Graf
Georg Fuernau
Marcus Franz
Ralf Westenfeld
Malte Kelm
Stephan B. Felix
Christian Jung
Publikationsdatum
26.04.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 1/2020
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-019-01482-2

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