OBJECTIVES: No guidelines for mechanical circulatory support in @entity1 with therapy-refractory @entity1455 and multiorgan failure including ongoing cardiopulmonary resuscitation (CPR) exist. To achieve immediate cardiopulmonary stabilization, we established an interdisciplinary concept with on-site percutaneous extracorporeal life support (ECLS) implantation. METHODS: From February 2012 to November 2014, 96 @entity1 were deemed eligible for ECLS implantation. Establishing ECLS was successful in 87 @entity1 (mean age 54    13 years, 16% female, initial flow 4.4    0.9 l/min). Aetiologies included @entity1187 (n = 52, 60%), @entity296 (n = 25, 29%) and other pathologies. Fifty-nine @entity1 (68%) had been resuscitated, and in 27 (31%), implantation was performed during CPR; 11 @entity1 (13%) were awake at implantation and 20 (23%) underwent implantation in the referring hospital. RESULTS: Metabolic parameters differed in non-survivors versus survivors before ECLS implantation (pH 7.15    0.23 vs. 7.27    0.18, P = 0.007; @entity880 levels 10.90    6.00 mmol/l vs. 8.79    5.78 mmol/l, P = 0.091) and 6 h postimplantation (pH 7.27    0.11 vs. 7.37    0.11, P < 0.001; @entity880 levels 10.19    5.52 mmol/l vs. 5.52    4.17 mmol/l, P < 0.001). Altogether 44 @entity1 could be weaned, and 9 were bridged to assist device implantation and 1 to heart transplantation. The mean time of support was 6 days, and the 30-day survival rate was 47% (n = 41). CONCLUSIONS: ECLS serves as a bridge-to-decision and bridge-to-treatment device. Our interdisciplinary ECLS programme achieved acceptable survival of critically ill @entity1 despite a substantial percentage of @entity1 having been resuscitated and no absolute exclusion criteria. Further studies defining inclusion- and exclusion criteria might additionally improve outcome.

When all else fails: extracorporeal life support in therapy-refractory XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndromes'] @entity296 :: ('MESH:D009202', 'Disease') :: ['cardiomyopathies'] @entity880 :: ('MESH:D019344', 'Chemical') :: ['lactate'] @entity1455 :: ('MESH:D012770', 'Disease') :: ['cardiogenic shock']
@entity1455 :: (MESH:D012770,Disease) :: ['cardiogenic shock']
