Outcomes of Veno-Arterial Extracorporeal Membrane Oxygenation: Insights from a Single-center Retrospective Study

INTRODUCTION: ECMO has become an essential tool in the management of complex cardiorespiratory failure where other interventions faded to work. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) also known as extracorporeal life support (ECLS) is available for circulatory support in patients with cardiogenic shock in many institutions worldwide and the utilization has been increasing annually. OBJECTIVES: The purpose of this study is to examine survival prognostic and extracorporeal membrane oxygenation (VA-ECMO) application outcomes at our tertiary care center MATERIALS AND METHODS: We retrospectively reviewed the experience of our hospital from august 2022 September 2024. Baseline characteristics of patients, ECMO indication, scoring systems, time to initiation, Hospital days, ICU days, ECMO duration, successful weaning and survival rate were assessed. RESULTS: On reviewing 22 cases of ECMO were done in patients with varied indications majority being VA ECMO(15/22;68%) secondary to Acute Myocardial infarction with cardiogenic shock SCAI D->E(9/15;60%). Mean age of the patient was 49.4 ± 14.24 years with male preponderance (11/15,73.3%). eCPR was done in two patients out of which one patient survived to discharge. All cannulations were percutaneous (90.9%), done in Cath lab except for 2 where one had morbid obesity and second had high bifurcation. Mean duration of ECMO was 4.73± 2.84 days. mean ICU Length of stay was 9.27±7.12 and hospital length of stay was 11.93±8.33. Most common cause of death in VA ECMO was poor neurological performance(1). 53.3% were successfully weaned and decannulated(8/15), however only 7/15 were discharged home. Scoring systems used to prognosticate were SAVE and PREDICT -VA. The most frequently observed complication was deep vein thrombosis(2) (28.57%). CONCLUSIONS: The study on veno-arterial ECMO outcomes reveals a 53.3% successful weaning rate among patients, primarily used for acute myocardial infarction with cardiogenic shock. While early intervention is crucial, complications, particularly deep vein thrombosis, were common. Only 7 out of 15 patients were discharged home, emphasizing the importance of careful patient selection and post-ECMO care. Overall, despite its vital role in critical cardiac cases, further research is needed to improve outcomes and reduce complications associated with VA-ECMO.