ECMO Cannulation and Management
All patients had cardiac arrest, either as an initial presentation or in-hospital after presentation. The patients required CPR before cannulation for ECMO, with a range of 3 to 50 minutes of CPR. 8 of 29 patients (27.5%) were placed on ECMO during CPR, and the remaining patients were placed on ECMO after successful CPR at an outside or inside of the hospital. Six patients had in-hospital onset, with diagnosis during the hospitalization of acute myocardial infarction, post abdominal surgery and severe pneumonia. All patients had VA- ECMO, 26 patients had femoral, three patients had central, respectively. Mean ECMO duration was 3.5 ± 1.1 days for survivor patients, ranging from 2-11 days.
All patients underwent APT therapy using the EKOS system. No other catheter-based procedures (e.g. Percutaneous mechanical thrombectomy) were performed. The mean tissue plasminogen activator (tPA) dose for survivor patients was 20.5 ± 1.6 mg and the mean infusion time was 16.2 ± 3.1 hours (Table 3).