Veno-Arterial Extracorporeal Membrane Oxygenation Support in Patients Undergoing Aortic Surgery
| Autor: | Chunjing Jiang, Hong Wang, Zhao-peng Zhong, Xing Hao, Xiaotong Hou, Feng Yang, Jialin Xing |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Biomedical Engineering Medicine (miscellaneous) Bioengineering 030204 cardiovascular system & hematology Biomaterials 03 medical and health sciences 0302 clinical medicine Refractory Extracorporeal membrane oxygenation Medicine Cause of death business.industry Cardiogenic shock Organ dysfunction General Medicine Odds ratio Perioperative medicine.disease Surgery 030228 respiratory system Anesthesia medicine.symptom business Perfusion |
| Zdroj: | Artificial Organs. 41:1113-1120 |
| ISSN: | 0160-564X |
| DOI: | 10.1111/aor.12951 |
| Popis: | Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included. Preoperative, perioperative, and postoperative variables were assessed and analyzed for possible correlation with in-hospital mortality. After a mean duration of 3.6 ± 2.9 days, 24 patients (67%) were weaned off VA-ECMO, and 18 patients (50%) were discharged from the hospital. The overall in-hospital mortality was 50%. The main cause of death was multiple organ dysfunction. The survivors had a lower level of preoperative creatine kinase-MB (CK-MB), a higher rate of antegrade cannulation, and a lower lactate level at 12 h, respectively. Relevant factors for in-hospital mortality were retrograde-flow cannulation (odds ratio [OR], 2.49), peak lactate levels greater than 20 mmol/L (OR, 5.0), and preoperative CK-MB greater than 100 IU/L (OR, 6.40). Antegrade cannulation may provide better perfusion and should be emphasized to improve outcomes. Additionally, levels of peak serum lactate and preoperative CK-MB may be relevant factors for in-hospital mortality in aortic patients with PCS. |
| Databáze: | OpenAIRE |
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