Background:This study identified predictors of hospital mortality after successful weaning of patients with cardiogenic shock off venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support.

Methods and Results:Adult patients who received peripheral VA ECMO from January 2012 to April 2017 were reviewed retrospectively. After excluding patients who died on ECMO support, predictors for survival to discharge were investigated in patients who were successfully weaned off ECMO. Of 191 patients successfully weaned off ECMO, 143 (74.9%) survived to discharge. The prevalence of a history of stroke and coronary artery disease, as well as ECMO-related complications, including newly developed stroke and sepsis, was a higher in patients who did not survive to discharge than in those who did. On the day of ECMO weaning, Sequential Organ Failure Assessment score and serum lactate were higher in patients who did not survive to discharge, although there was no significant difference in blood pressure and the use of vasoactive drugs between the 2 groups. On multivariable analysis, stroke and sepsis during ECMO support, a lower Glasgow Coma Scale and acute kidney injury requiring continuous renal replacement therapy after weaning were significant predictors for in-hospital mortality.

Conclusions:Complications that occurred during ECMO and the presence of extracardiac organ dysfunction after weaning were associated with in-hospital mortality in patients with cardiogenic shock who were successfully weaned off ECMO.

背景：本研究确定了心源性休克患者在成功撤机后停用静脉动脉 (VA) 体外膜肺氧合 (ECMO) 支持后住院死亡率的预测因素。

方法和结果：对 2012 年 1 月至 2017 年 4 月接受外周 VA ECMO 的成年患者进行回顾性研究。在排除因 ECMO 支持而死亡的患者后，对成功脱离 ECMO 的患者的出院生存预测因子进行了调查。在 191 名成功脱离 ECMO 的患者中，143 名 (74.9%) 存活出院。中风和冠状动脉疾病史以及 ECMO 相关并发症（包括新发中风和败血症）的患病率在未能存活出院的患者中高于存活出院的患者。在 ECMO 撤机当天，尽管两组在血压和血管活性药物的使用方面没有显着差异，但未能存活出院的患者的序贯器官衰竭评估评分和血清乳酸更高。

结论： ECMO期间发生的并发症和撤机后心外器官功能障碍的存在与成功撤机ECMO的心源性休克患者的院内死亡率相关。