Göçer Hakan, Durukan Ahmet Baris, Naseri Erdinç, Ünal Mustafa
Private Korfez Hospital, Edremit, Balıkesir, Turkey.
MediGüneş, Salihli Private Hospital, Salihli, Manisa, Turkey.
Kardiochir Torakochirurgia Pol. 2020 Dec;17(4):189-192. doi: 10.5114/kitp.2020.102333. Epub 2021 Jan 15.
Veno-venous extracorporeal membrane oxygenation (ECMO) support has been used for respiratory insufficiency. Its role in blood oxygenation has been well documented. However, the effects on myocardial electrophysiology have not been studied in detail.
To reveal the acute effects of extracorporeal support on new electrocardiography (ECG) parameters in patients with preserved left ventricular functions.
This retrospective study was conducted in three separate clinics. Sixteen consecutive patients under veno-venous ECMO for respiratory insufficiency who soon could be successfully weaned were analyzed. Immediately before and 2 hours after initiation of ECMO, ECG was performed. P wave, QT, QTc and T wave peak to end were measured and calculated from obtained surface 12-lead ECG.
There were statistically significant differences immediately before and 2 hours after initiation of ECMO treatment in the Tp-e interval and Tp-e/QTc ratio, the maximum QTc, minimum QTc, and QTc dispersion values, and P wave dispersion ( < 0.0001 for each). All ECG parameters were significantly decreased with ECMO support.
All atrial and ventricular repolarization parameters were decreased in patients with VV-ECMO support. Despite the limited role of ECMO in intractable arrhythmias, the findings of the study revealed that ECMO therapy for respiratory insufficiency may improve atrial ventricular depolarization and repolarization. Therefore, simple 12-lead surface ECG with new ECG parameters may be evaluated for better outcomes.
静脉 - 静脉体外膜肺氧合(ECMO)支持已用于呼吸功能不全。其在血液氧合中的作用已有充分记录。然而,对心肌电生理的影响尚未进行详细研究。
揭示体外支持对左心室功能保留患者新心电图(ECG)参数的急性影响。
这项回顾性研究在三个不同的诊所进行。分析了16例因呼吸功能不全接受静脉 - 静脉ECMO治疗且很快能够成功撤机的连续患者。在启动ECMO之前和之后2小时立即进行心电图检查。从获得的12导联体表心电图中测量并计算P波、QT、QTc和T波峰到末间期。
在启动ECMO治疗之前和之后2小时,Tp - e间期、Tp - e/QTc比值、最大QTc、最小QTc和QTc离散度值以及P波离散度存在统计学显著差异(每项均<0.0001)。所有心电图参数在ECMO支持下均显著降低。
接受VV - ECMO支持的患者所有心房和心室复极参数均降低。尽管ECMO在难治性心律失常中的作用有限,但该研究结果表明,用于呼吸功能不全的ECMO治疗可能改善心房心室的去极化和复极化。因此,可评估具有新心电图参数的简单12导联体表心电图以获得更好的结果。