Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study

  1. Chiarini, Giovanni
  2. Mariani, Silvia
  3. Schaefer, Anne-Kristin
  4. van Bussel, Bas C. T.
  5. Di Mauro, Michele
  6. Wiedemann, Dominik
  7. Saeed, Diyar
  8. Pozzi, Matteo
  9. Botta, Luca
  10. Boeken, Udo
  11. Samalavicius, Robertas
  12. Bounader, Karl
  13. Hou, Xiaotong
  14. Bunge, Jeroen J. H.
  15. Buscher, Hergen
  16. Salazar, Leonardo
  17. Meyns, Bart
  18. Herr, Daniel
  19. Matteucci, Sacha
  20. Sponga, Sandro
  21. Ramanathan, Kollengode
  22. Russo, Claudio
  23. Formica, Francesco
  24. Sakiyalak, Pranya
  25. Fiore, Antonio
  26. Camboni, Daniele
  27. Raffa, Giuseppe Maria
  28. Diaz, Rodrigo
  29. Wang, I-wen
  30. Jung, Jae-Seung
  31. Belohlavek, Jan
  32. Pellegrino, Vin
  33. Bianchi, Giacomo
  34. Pettinari, Matteo
  35. Barbone, Alessandro
  36. Garcia, José P.
  37. Shekar, Kiran
  38. Whitman, Glenn J. R.
  39. Lorusso, Roberto
  40. on behalf of the PELS Investigators
  41. Heuts, Samuel
  42. Conci, Luca
  43. Khalil, Jawad
  44. Lehmann, Sven
  45. Obadia, Jean-Francois
  46. Loforte, Antonio
  47. Pacini, Davide
  48. Kalampokas, Nikolaos
  49. Jankuviene, Agne
  50. Bounader, Karl
  51. Flecher, Erwan
  52. Dos Reis Miranda, Dinis
  53. Sriranjan, Kogulan
  54. Mazzeffi, Michael A.
  55. Di Eusanio, Marco
  56. Vendramin, Igor
  57. MacLaren, Graeme
  58. Sorokin, Vitaly
  59. Costetti, Alessandro
  60. Schmid, Chistof
  61. Castillo, Roberto
  62. Grus, Tomas
  63. Solinas, Marco

Download
13054_2024_Article_5047.pdf 1,53MB
WeightNameValue
1000 Titel
  • Neurologic complications in patients receiving aortic versus subclavian versus femoral arterial cannulation for post-cardiotomy extracorporeal life support: results of the PELS observational multicenter study
1000 Autor/in
  1. Chiarini, Giovanni |
  2. Mariani, Silvia |
  3. Schaefer, Anne-Kristin |
  4. van Bussel, Bas C. T. |
  5. Di Mauro, Michele |
  6. Wiedemann, Dominik |
  7. Saeed, Diyar |
  8. Pozzi, Matteo |
  9. Botta, Luca |
  10. Boeken, Udo |
  11. Samalavicius, Robertas |
  12. Bounader, Karl |
  13. Hou, Xiaotong |
  14. Bunge, Jeroen J. H. |
  15. Buscher, Hergen |
  16. Salazar, Leonardo |
  17. Meyns, Bart |
  18. Herr, Daniel |
  19. Matteucci, Sacha |
  20. Sponga, Sandro |
  21. Ramanathan, Kollengode |
  22. Russo, Claudio |
  23. Formica, Francesco |
  24. Sakiyalak, Pranya |
  25. Fiore, Antonio |
  26. Camboni, Daniele |
  27. Raffa, Giuseppe Maria |
  28. Diaz, Rodrigo |
  29. Wang, I-wen |
  30. Jung, Jae-Seung |
  31. Belohlavek, Jan |
  32. Pellegrino, Vin |
  33. Bianchi, Giacomo |
  34. Pettinari, Matteo |
  35. Barbone, Alessandro |
  36. Garcia, José P. |
  37. Shekar, Kiran |
  38. Whitman, Glenn J. R. |
  39. Lorusso, Roberto |
  40. on behalf of the PELS Investigators |
  41. Heuts, Samuel |
  42. Conci, Luca |
  43. Khalil, Jawad |
  44. Lehmann, Sven |
  45. Obadia, Jean-Francois |
  46. Loforte, Antonio |
  47. Pacini, Davide |
  48. Kalampokas, Nikolaos |
  49. Jankuviene, Agne |
  50. Bounader, Karl |
  51. Flecher, Erwan |
  52. Dos Reis Miranda, Dinis |
  53. Sriranjan, Kogulan |
  54. Mazzeffi, Michael A. |
  55. Di Eusanio, Marco |
  56. Vendramin, Igor |
  57. MacLaren, Graeme |
  58. Sorokin, Vitaly |
  59. Costetti, Alessandro |
  60. Schmid, Chistof |
  61. Castillo, Roberto |
  62. Grus, Tomas |
  63. Solinas, Marco |
1000 Verlag BioMed Central
1000 Erscheinungsjahr 2024
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2024-08-07
1000 Erschienen in
1000 Quellenangabe
  • 28(1):265
1000 Copyrightjahr
  • 2024
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13054-024-05047-2 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304572/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Cerebral perfusion may change depending on arterial cannulation site and may affect the incidence of neurologic adverse events in post-cardiotomy extracorporeal life support (ECLS). The current study compares patients' neurologic outcomes with three commonly used arterial cannulation strategies (aortic vs. subclavian/axillary vs. femoral artery) to evaluate if each ECLS configuration is associated with different rates of neurologic complications.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This retrospective, multicenter (34 centers), observational study included adults requiring post-cardiotomy ECLS between January 2000 and December 2020 present in the Post-Cardiotomy Extracorporeal Life Support (PELS) Study database. Patients with Aortic, Subclavian/Axillary and Femoral cannulation were compared on the incidence of a composite neurological end-point (ischemic stroke, cerebral hemorrhage, brain edema). Secondary outcomes were overall in-hospital mortality, neurologic complications as cause of in-hospital death, and post-operative minor neurologic complications (seizures). Association between cannulation and neurological outcomes were investigated through linear mixed-effects models.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>This study included 1897 patients comprising 26.5% Aortic (n = 503), 20.9% Subclavian/Axillary (n = 397) and 52.6% Femoral (n = 997) cannulations. The Subclavian/Axillary group featured a more frequent history of hypertension, smoking, diabetes, previous myocardial infarction, dialysis, peripheral artery disease and previous stroke. Neuro-monitoring was used infrequently in all groups. Major neurologic complications were more frequent in Subclavian/Axillary (Aortic: n = 79, 15.8%; Subclavian/Axillary: n = 78, 19.6%; Femoral: n = 118, 11.9%; <jats:italic>p</jats:italic> &lt; 0.001) also after mixed-effects model adjustment (OR 1.53 [95% CI 1.02–2.31], <jats:italic>p</jats:italic> = 0.041). Seizures were more common in Subclavian/Axillary (n = 13, 3.4%) than Aortic (n = 9, 1.8%) and Femoral cannulation (n = 12, 1.3%, <jats:italic>p</jats:italic> = 0.036). In-hospital mortality was higher after Aortic cannulation (Aortic: n = 344, 68.4%, Subclavian/Axillary: n = 223, 56.2%, Femoral: n = 587, 58.9%, <jats:italic>p</jats:italic> &lt; 0.001), as shown by Kaplan–Meier curves. Anyhow, neurologic cause of death (Aortic: n = 12, 3.9%, Subclavian/Axillary: n = 14, 6.6%, Femoral: n = 28, 5.0%, <jats:italic>p</jats:italic> = 0.433) was similar.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In this analysis of the PELS Study, Subclavian/Axillary cannulation was associated with higher rates of major neurologic complications and seizures. In-hospital mortality was higher after Aortic cannulation, despite no significant differences in incidence of neurological cause of death in these patients. These results encourage vigilance for neurologic complications and neuromonitoring use in patients on ECLS, especially with Subclavian/Axillary cannulation.</jats:p> </jats:sec><jats:sec> <jats:title>Graphical abstract</jats:title> </jats:sec>
1000 Sacherschließung
lokal Cardiac Surgical Procedures/adverse effects [MeSH]
lokal Aged [MeSH]
lokal Hospital Mortality/trends [MeSH]
lokal Neurologic complications
lokal Postoperative Complications/epidemiology [MeSH]
lokal Cardiac arrest
lokal Catheterization, Peripheral/adverse effects [MeSH]
lokal Nervous System Diseases/etiology [MeSH]
lokal Extracorporeal Membrane Oxygenation/statistics
lokal Stroke
lokal Aorta [MeSH]
lokal Cardiac Surgical Procedures/methods [MeSH]
lokal Extracorporeal Membrane Oxygenation/methods [MeSH]
lokal Male [MeSH]
lokal Postoperative Complications/etiology [MeSH]
lokal Extracorporeal membrane oxygenation
lokal Femoral Artery [MeSH]
lokal Catheterization/methods [MeSH]
lokal Female [MeSH]
lokal Catheterization/adverse effects [MeSH]
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Nervous System Diseases/epidemiology [MeSH]
lokal Retrospective Studies [MeSH]
lokal Middle Aged [MeSH]
lokal Catheterization, Peripheral/methods [MeSH]
lokal ICH
lokal Extracorporeal Membrane Oxygenation/adverse effects [MeSH]
lokal Catheterization, Peripheral/statistics
lokal Catheterization/statistics
lokal Research
lokal Subclavian Artery [MeSH]
lokal Cardiac surgery
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/Q2hpYXJpbmksIEdpb3Zhbm5p|https://frl.publisso.de/adhoc/uri/TWFyaWFuaSwgU2lsdmlh|https://frl.publisso.de/adhoc/uri/U2NoYWVmZXIsIEFubmUtS3Jpc3Rpbg==|https://frl.publisso.de/adhoc/uri/dmFuIEJ1c3NlbCwgQmFzIEMuIFQu|https://frl.publisso.de/adhoc/uri/RGkgTWF1cm8sIE1pY2hlbGU=|https://frl.publisso.de/adhoc/uri/V2llZGVtYW5uLCBEb21pbmlr|https://frl.publisso.de/adhoc/uri/U2FlZWQsIERpeWFy|https://frl.publisso.de/adhoc/uri/UG96emksIE1hdHRlbw==|https://frl.publisso.de/adhoc/uri/Qm90dGEsIEx1Y2E=|https://frl.publisso.de/adhoc/uri/Qm9la2VuLCBVZG8=|https://frl.publisso.de/adhoc/uri/U2FtYWxhdmljaXVzLCBSb2JlcnRhcw==|https://frl.publisso.de/adhoc/uri/Qm91bmFkZXIsIEthcmw=|https://frl.publisso.de/adhoc/uri/SG91LCBYaWFvdG9uZw==|https://frl.publisso.de/adhoc/uri/QnVuZ2UsIEplcm9lbiBKLiBILg==|https://frl.publisso.de/adhoc/uri/QnVzY2hlciwgSGVyZ2Vu|https://frl.publisso.de/adhoc/uri/U2FsYXphciwgTGVvbmFyZG8=|https://frl.publisso.de/adhoc/uri/TWV5bnMsIEJhcnQ=|https://frl.publisso.de/adhoc/uri/SGVyciwgRGFuaWVs|https://frl.publisso.de/adhoc/uri/TWF0dGV1Y2NpLCBTYWNoYQ==|https://frl.publisso.de/adhoc/uri/U3BvbmdhLCBTYW5kcm8=|https://frl.publisso.de/adhoc/uri/UmFtYW5hdGhhbiwgS29sbGVuZ29kZQ==|https://frl.publisso.de/adhoc/uri/UnVzc28sIENsYXVkaW8=|https://frl.publisso.de/adhoc/uri/Rm9ybWljYSwgRnJhbmNlc2Nv|https://frl.publisso.de/adhoc/uri/U2FraXlhbGFrLCBQcmFueWE=|https://frl.publisso.de/adhoc/uri/RmlvcmUsIEFudG9uaW8=|https://frl.publisso.de/adhoc/uri/Q2FtYm9uaSwgRGFuaWVsZQ==|https://frl.publisso.de/adhoc/uri/UmFmZmEsIEdpdXNlcHBlIE1hcmlh|https://frl.publisso.de/adhoc/uri/RGlheiwgUm9kcmlnbw==|https://frl.publisso.de/adhoc/uri/V2FuZywgSS13ZW4=|https://frl.publisso.de/adhoc/uri/SnVuZywgSmFlLVNldW5n|https://frl.publisso.de/adhoc/uri/QmVsb2hsYXZlaywgSmFu|https://frl.publisso.de/adhoc/uri/UGVsbGVncmlubywgVmlu|https://frl.publisso.de/adhoc/uri/QmlhbmNoaSwgR2lhY29tbw==|https://frl.publisso.de/adhoc/uri/UGV0dGluYXJpLCBNYXR0ZW8=|https://frl.publisso.de/adhoc/uri/QmFyYm9uZSwgQWxlc3NhbmRybw==|https://frl.publisso.de/adhoc/uri/R2FyY2lhLCBKb3PDqSBQLg==|https://frl.publisso.de/adhoc/uri/U2hla2FyLCBLaXJhbg==|https://frl.publisso.de/adhoc/uri/V2hpdG1hbiwgR2xlbm4gSi4gUi4=|https://frl.publisso.de/adhoc/uri/TG9ydXNzbywgUm9iZXJ0bw==|https://frl.publisso.de/adhoc/uri/b24gYmVoYWxmIG9mIHRoZSBQRUxTIEludmVzdGlnYXRvcnM=|https://frl.publisso.de/adhoc/uri/SGV1dHMsIFNhbXVlbA==|https://frl.publisso.de/adhoc/uri/Q29uY2ksIEx1Y2E=|https://frl.publisso.de/adhoc/uri/S2hhbGlsLCBKYXdhZA==|https://frl.publisso.de/adhoc/uri/TGVobWFubiwgU3Zlbg==|https://frl.publisso.de/adhoc/uri/T2JhZGlhLCBKZWFuLUZyYW5jb2lz|https://frl.publisso.de/adhoc/uri/TG9mb3J0ZSwgQW50b25pbw==|https://frl.publisso.de/adhoc/uri/UGFjaW5pLCBEYXZpZGU=|https://frl.publisso.de/adhoc/uri/S2FsYW1wb2thcywgTmlrb2xhb3M=|https://frl.publisso.de/adhoc/uri/SmFua3V2aWVuZSwgQWduZQ==|https://frl.publisso.de/adhoc/uri/Qm91bmFkZXIsIEthcmw=|https://frl.publisso.de/adhoc/uri/RmxlY2hlciwgRXJ3YW4=|https://frl.publisso.de/adhoc/uri/RG9zIFJlaXMgTWlyYW5kYSwgRGluaXM=|https://frl.publisso.de/adhoc/uri/U3JpcmFuamFuLCBLb2d1bGFu|https://frl.publisso.de/adhoc/uri/TWF6emVmZmksIE1pY2hhZWwgQS4=|https://frl.publisso.de/adhoc/uri/RGkgRXVzYW5pbywgTWFyY28=|https://frl.publisso.de/adhoc/uri/VmVuZHJhbWluLCBJZ29y|https://frl.publisso.de/adhoc/uri/TWFjTGFyZW4sIEdyYWVtZQ==|https://frl.publisso.de/adhoc/uri/U29yb2tpbiwgVml0YWx5|https://frl.publisso.de/adhoc/uri/Q29zdGV0dGksIEFsZXNzYW5kcm8=|https://frl.publisso.de/adhoc/uri/U2NobWlkLCBDaGlzdG9m|https://frl.publisso.de/adhoc/uri/Q2FzdGlsbG8sIFJvYmVydG8=|https://frl.publisso.de/adhoc/uri/R3J1cywgVG9tYXM=|https://frl.publisso.de/adhoc/uri/U29saW5hcywgTWFyY28=
1000 Hinweis
  • DeepGreen-ID: 63673508ccf94210bddf22d3e3dcd2f7 ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
1000 Label
1000 Dateien
1000 Objektart article
1000 Beschrieben durch
1000 @id frl:6520041.rdf
1000 Erstellt am 2025-07-05T22:12:19.675+0200
1000 Erstellt von 322
1000 beschreibt frl:6520041
1000 Zuletzt bearbeitet 2025-08-11T08:05:27.792+0200
1000 Objekt bearb. Mon Aug 11 08:05:27 CEST 2025
1000 Vgl. frl:6520041
1000 Oai Id
  1. oai:frl.publisso.de:frl:6520041 |
1000 Sichtbarkeit Metadaten public
1000 Sichtbarkeit Daten public
1000 Gegenstand von

View source