体外膜肺氧合后左心室卸载不足：一项病例系列观察性研究。
Insufficient left ventricular unloading after extracorporeal membrane oxygenation : A case-series observational study.
作者信息
Hu W, Zhou J, Chen L, Huang J, Hu W, Zhu Y, Yuan T
机构信息
Department of Critical Care Medicine, The Affiliated Hangzhou Hospital of Nanjing Medical University, 310006, Zhejiang, China.
Department of Cardiac Rehabilitation, Zhejiang Hospital, 310013, Zhejiang, China.
出版信息
Herz. 2020 Apr;45(2):186-191. doi: 10.1007/s00059-018-4711-5. Epub 2018 May 18.
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) is a method widely used to support circulation in patients with fulminant myocarditis (FM). However, a common complication associated with ECMO is left ventricular (LV) overload.
METHODS
This case series observed the effects of intra-aortic balloon pump (IABP) and beta-blockers for the treatment of LV overload after ECMO. The cases of eight patients with FM who underwent ECMO from September 2009 to July 2016 were reviewed.
RESULTS
Six of the eight patients survived. After ECMO treatment, insufficient LV unloading occurred in six patients. Among these six patients, three experienced electrical storm but spontaneous circulation returned after interventions with beta-blockers and IABP. The survivors demonstrated full recovery of cardiac function.
CONCLUSION
Beta-blockers may prevent the occurrence of electrical storm, and IABP is feasible for the treatment of LV overload after ECMO application.
背景
体外膜肺氧合（ECMO）是一种广泛用于支持暴发性心肌炎（FM）患者循环的方法。然而，与ECMO相关的常见并发症是左心室（LV）负荷过重。
方法
本病例系列观察了主动脉内球囊反搏（IABP）和β受体阻滞剂治疗ECMO后左心室负荷过重的效果。回顾了2009年9月至2016年7月接受ECMO治疗的8例FM患者的病例。
结果
8例患者中有6例存活。ECMO治疗后，6例患者左心室卸载不足。在这6例患者中，3例发生电风暴，但在使用β受体阻滞剂和IABP干预后恢复了自主循环。幸存者的心功能完全恢复。
结论
β受体阻滞剂可能预防电风暴的发生，IABP对治疗ECMO应用后的左心室负荷过重是可行的。
Zotero 插件