Comparison of Mechanical Support with Impella or Extracorporeal Life Support in Post-Cardiac Arrest Cardiogenic Shock: A Propensity Scoring Matching Analysis

• DOI: 10.3390/jcm10163583
• Publication Date: 2021-08-16T01:43:55Z
• Authors: Styliani Syntila; Georgios Chatzis; Birgit Markus; Holger Ahrens; Christian Waechter; Ulrich Luesebrink; Dimitar Divchev; Harald Schuett; Panagiota-Eleni T...; Andreas Jerrentrup; Mariana Parahuleva; Bernhard Schieffer; Konstantinos Kara...
• Keywords: Impella; Extracorporeal; Cardiac index

Our aim was to compare the outcomes of Impella with extracorporeal life support (ECLS) in patients post-cardiac arrest cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This a retrospective study resuscitated from out hospital cardiac (OHCA) CS following AMI (May 2015 May 2020). Patients were supported either 2.5/CP or ECLS. Outcomes compared using propensity score-matched analysis account for differences baseline characteristics between groups. 159 included (Impella, n = 105; ECLS, 54). Hospital and 12-month survival rates comparable ECLS groups (p 0.16 p 0.3, respectively). After adjustment differences, both demonstrated 0.36 0.64, had significantly greater left ventricle ejection-fraction (LVEF) improvement at 96 h < 0.01 vs. 0.44 ECLS) fewer device-associated complications than (15.2% versus 35.2%, relevant access site bleeding, 7.6% 20.4%, 0.04 limb ischemia needing intervention). In subgroup analyses, associated better lower-risk features (lactate 8.6 mmol/L, time collapse return spontaneous circulation 28 min, vasoactive score 46 Horowitz index > 182). conclusion, use after adjusted survival. LVEF patients. Device-related access-site occurred more frequently support.