Vaso-inotropic Score and ECMO-VA Support in Post-cardiotomy Cardiogenic Shock.

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a well-established lifesaving treatment for refractory cardiogenic shock, with or without concomitant respiratory failure. VA-ECMO is usually started in presence of refractory low cardiac output syndrome following CPB weaning. Currently, there is no consensus about the best timing for implantation and initiation of VA-ECMO in this setting. Some publications have suggested that VIS score could be used to determine the necessity of VA-ECMO in cardiologic area. It was demonstrated that a VIS score between 20 and 40 may be a cut-off value to discuss the implantation of VA-ECMO. Post cardiotomy shock is a very interesting setting because the timing of cardiogenic shock is known and several bias are more controlled than in medical area. Based on the well-established ability of VIS Score in predicting mortality, we will investigate the role of the VIS Score as a determinant for early VA-ECMO implantation in patients suffering of post-cardiotomy cardiogenic shock.

Inclusion Criteria: * age over 18 years * Cardiac surgery with cardiopulmonary bypass * Post cardiotomy cardiogenic shock * ECMO-VA implanted in OR Exclusion Criteria: * LVAD * Heart transplantation * Incomplete data in relation to outcomes * Cardiac arrest