Musiał Robert, Ochońska Krystyna, Proc Andrzej, Stoliński Jarosław, Plicner Dariusz, Kapelak Bogusław, Drwiła Rafał
Department of Anesthesiology and Intensive Therapy, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland.
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland.
Kardiochir Torakochirurgia Pol. 2017 Mar;14(1):32-36. doi: 10.5114/kitp.2017.66927. Epub 2017 Mar 31.
The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock.
The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed.
We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO. We compared the number of days on VA ECMO therapy, types of cardiac surgical procedures, and the frequency of VA ECMO complications such as coagulation disorders, lower limb ischemia, cardiac tamponade, and renal replacement therapy.
There were 27 patients treated with VA ECMO during the study period. The mean patient age was 45 ±16 years. The hospital mortality rate of patients treated with VA ECMO therapy was 70% (19/27). There were no significant differences between the groups of survivors and non-survivors regarding age, gender, admission type and coexisting diseases. Type of cardiac surgical procedure had no influence on mortality or complications of therapy using VA ECMO.
The VA ECMO can be an effective form of therapy in some patients in postcardiotomy cardiogenic shock.
作者介绍了他们在对心脏手术后心源性休克的成年患者进行体外膜肺氧合(ECMO)静脉 - 动脉(VA)支持及治疗方面的个人经验。
本研究旨在分析VA - ECMO治疗心脏手术后心源性休克患者的结果。同时也对术后死亡的危险因素进行了分析。
我们分析了接受VA - ECMO治疗的存活者和非存活者的围手术期结果。比较了VA - ECMO治疗的天数、心脏手术类型以及VA - ECMO并发症的发生率,如凝血功能障碍、下肢缺血、心脏压塞和肾脏替代治疗。
研究期间共有27例患者接受了VA - ECMO治疗。患者平均年龄为45±16岁。接受VA - ECMO治疗的患者医院死亡率为70%(19/27)。在年龄、性别、入院类型和并存疾病方面,存活组和非存活组之间没有显著差异。心脏手术类型对VA - ECMO治疗的死亡率或并发症没有影响。
对于某些心脏手术后心源性休克患者,VA - ECMO可能是一种有效的治疗方式。