Predictors for myocardial recovery of patients implanted with an ECMO device following myocardial infarction

Introduction Extracorporeal membrane oxygenation (ECMO) has become the most widely used circulatory aid in refractory cardiogenic shock (CS). There is little data available on the predictive markers of a favorable outcome following myocardial infarction. Objective To identify the factors predictive of the successful withdrawal of ECMO implanted for refractory CS of ischemic origin. Methods This was an observational retrospective single-center study. The patients were distributed into two groups: successful (55%) or non successful (45%) ECMO weaning. Results Sixty-five patients were included between January 2008 and March 2017 in the Poitiers University Hospital (CHU). Complete coronary revascularisation was achieved mainly in the in the “successful weaning” group, P  = 0.058. The 30-day survival rate was 43%. A history of myocardial infarction, [0.03–0.92, P  = 0.039], initial ventricular rhythm disorders (RD) [1.33–19.17, P  = 0.018] and the hemoglobin level [0.58–0.96, P  = 0.021] were revealed as independent predictive factors for successful weaning from ECMO. Conclusion The early use of ECMO is an effective rescue strategy which provides recovery of myocardial function in close to 55% of cases. The occurrence of de ventricular RD (OR = 5) on admission is predictive of greater survival.