Liden H, Wiklund L, Haraldsson A, Berglin E, Hultman J, Dellgren G
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Scand Cardiovasc J. 2009 Aug;43(4):226-32. doi: 10.1080/14017430802596420.
Early and long-term survival in patients suffering from cardiogenic shock is poor. Treatment with mechanical assist devices is complicated and expensive but claim to improve survival. We reviewed our experience of venoarterial extracorporeal membrane oxygenation (ECMO) in patients with acute cardiogenic shock.
ECMO was used in 52 patients with cardiogenic shock. They were divided into those not operated upon previously (n=19) and those having had cardiac surgery prior to circulatory collapse (n=33).
Twenty-six patients were weaned from ECMO. Early mortality for all patients was 48%. Mortality beyond 30 days was 5.8%, with no mortality in the non-cardiotomy group. Long-term survival for patients in the non-cardiotomy group was 63%, as compared to 33% in post-cardiotomy patients (p=0.07). Age over 55 years, female gender or cannulation site did not appear to influence survival.
Mortality for patients in cardiogenic shock is very high. Treatment with ECMO in patients with refractory cardiogenic shock can be performed with good survival especially in non-surgical patients.
心源性休克患者的早期和长期生存率较低。使用机械辅助装置进行治疗复杂且昂贵，但据称可提高生存率。我们回顾了我们在急性心源性休克患者中应用静脉-动脉体外膜肺氧合（ECMO）的经验。
52例心源性休克患者使用了ECMO。他们被分为既往未接受手术的患者（n = 19）和循环衰竭前接受过心脏手术的患者（n = 33）。
26例患者成功撤机。所有患者的早期死亡率为48%。30天以上的死亡率为5.8%，非心脏切开术组无死亡病例。非心脏切开术组患者的长期生存率为63%，而心脏切开术后患者为33%（p = 0.07）。年龄超过55岁、女性或插管部位似乎不影响生存率。
心源性休克患者的死亡率非常高。对于难治性心源性休克患者，尤其是非手术患者，应用ECMO治疗可获得较好的生存率。
