Sajjad Mohammad, Osman Ahmed, Mohsen Salah, Alanazi Mosleh, Ugurlucan Murat, Canver Charles
Department of Adult Cardiac Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Asian Cardiovasc Thorac Ann. 2013 Oct;21(5):521-7. doi: 10.1177/0218492312460858. Epub 2013 Jul 9.
The literature reports conflicting results for survival after extracorporeal membrane oxygenator support, and survival differs in pediatric and adult patients. We present our institutional experience of adult extracorporeal membrane oxygenator support.
From January 2007 to December 2009, 19 adult patients required extracorporeal membrane oxygenator support after cardiac surgery or catheter interventions. It was provided on an emergency basis to 11 patients, urgently to 5, and electively to 3. Indications included post-cardiotomy cardiogenic shock, post-cardiotomy acute respiratory failure, emergency cardiac resuscitation, and post-percutaneous coronary intervention cardiogenic shock. The mean duration of support was 4 days (range, 1-11 days).
Seven (36.84%) patients could be weaned off extracorporeal membrane oxygenator support; one (14.28%) of them survived to hospital discharge and the other 6 (85.71%) died in hospital. Twelve (63.15%) patients could not be weaned off and died while still on extracorporeal membrane oxygenator support. Overall 30-day hospital mortality was 94.73%, and survival to discharge was 5.26%.
Our institutional experience of extracorporeal membrane oxygenator support for cardiac indications in adult patients indicates poor survival. It significantly increased costs by delaying imminent death and prolonging stay in the intensive care unit.
文献报道了体外膜肺氧合支持后生存情况的相互矛盾的结果，且儿科和成年患者的生存情况有所不同。我们介绍我们机构在成年患者体外膜肺氧合支持方面的经验。
2007年1月至2009年12月，19例成年患者在心脏手术或导管介入后需要体外膜肺氧合支持。其中11例为紧急情况下提供支持，5例为急需，3例为择期。适应证包括心脏手术后心源性休克、心脏手术后急性呼吸衰竭、紧急心脏复苏以及经皮冠状动脉介入术后心源性休克。平均支持时间为4天（范围1 - 11天）。
7例（36.84%）患者能够撤掉体外膜肺氧合支持；其中1例（14.28%）存活至出院，另外6例（85.71%）死于医院。12例（63.15%）患者无法撤掉支持，在仍接受体外膜肺氧合支持时死亡。总体30天医院死亡率为94.73%，出院生存率为5.26%。
我们机构在成年患者心脏适应证体外膜肺氧合支持方面的经验表明生存率较低。它通过延迟临近死亡和延长重症监护病房住院时间显著增加了费用。
