Veno-arterio-venous ECMO for septic cardiomyopathy: a single-centre experience
| Autor: | Nicholas A Barrett, Nicholas Ioannou, Peter B. Sherren, Kathleen Daly, Chris Meadows, Luigi Camporota, Josie Murray, Nigel Gooby, Adam Z Czapran, Dominik J Vogel |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Cardiomyopathy 030204 cardiovascular system & hematology Extracorporeal 03 medical and health sciences Young Adult 0302 clinical medicine Extracorporeal Membrane Oxygenation medicine Retrospective analysis Humans Radiology Nuclear Medicine and imaging Septic cardiomyopathy Retrospective Studies Advanced and Specialized Nursing Septic shock business.industry 030208 emergency & critical care medicine Retrospective cohort study General Medicine Middle Aged medicine.disease Single centre Treatment Outcome Emergency medicine Female Cardiology and Cardiovascular Medicine business Cardiomyopathies Safety Research |
| Zdroj: | Perfusion. 33(1_suppl) |
| ISSN: | 1477-111X |
| Popis: | Introduction: The role of extracorporeal support for patients with septic shock remains unclear. Methods: We conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database. Results: Twelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3.0 to 5.3) between 01/2014 and 12/2017. Five patients (41.7%) had a cardiac arrest prior to initiation of ECMO support. At baseline, median left ventricular ejection fraction was 16.25% (IQR 13.13 to 17.5) and median PaO2/FiO2 ratio was 9 kPa (IQR 6.5 to 12.0) [67.50 mmHg (IQR 48.75 to 90.00)]. The survival rate to hospital discharge for VAV ECMO was 75% in this cohort. None of the surviving patients died within the follow-up period (median six month). Conclusion: VAV ECMO is a feasible rescue strategy for a small proportion of patients with combined respiratory and cardiac failure secondary to septic shock with septic cardiomyopathy. We provide a detailed report of our experience with this technique. Further research is required comparing the different extracorporeal strategies directly to conventional resuscitation and against each other. |
| Databáze: | OpenAIRE |
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