Document Detail


Extracorporeal membrane oxygenation support for postcardiotomy cardiogenic shock.
MedLine Citation:
PMID:  8947449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extracorporeal membrane oxygenation (ECMO) has had promising results in life-threatening respiratory failure and postcardiotomy cardiogenic failure. From October 1994 to October 1995, 18 patients received 19 ECMOs at National Taiwan University Hospital for severe cardiogenic shock after cardiac surgery. They included patients receiving cardiac massage or repeated bolus injections of norepinephrine to maintain blood pressure (n = 10), patients who could not be weaned off cardiopulmonary bypass after several attempts despite intraaortic balloon pumping and maximal doses of catecholamine (n = 7), and patients with progressive intractable cardiogenic shock after cardiac surgery. Venoarterial ECMO was set up via femoral artery (17 or 19 Fr cannula) and vein (19 or 21 Fr) in all patients except 2 infants. No left heart drainage was performed in any of the patients. The heparin-coated circuit (with Carmeda Bio-active Surface) was used in the last 13 patients to reduce bleeding. Ten (52.6%) of the 19 cases could be smoothly weaned off ECMO, and 6 (33.3%) of the 18 patients were discharged from the hospital in good condition. Four (80%) of the 5 patients after valvular surgery and all 3 heart transplant patients could be weaned off ECMO successfully with the survival rate being 60% and 67%, respectively. Complications included leg ischemia (n = 3), bleeding (n = 4), renal failure (n = 3), and tube rupture (n = 1). The inability to wean off ECMO was caused by multiple organ failure (n = 5), sepsis (n = 2), tube rupture (n = 1), and dysfunction of the ECMO system (n = 1). The major cause of multiple organ failure was hesitation to set up ECMO. Our preliminary results confirmed the effect of ECMO in postoperative cardiogenic shock.
Authors:
S S Wang; Y S Chen; W J Ko; S H Chu
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Artificial organs     Volume:  20     ISSN:  0160-564X     ISO Abbreviation:  Artif Organs     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-02-27     Completed Date:  1997-02-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1287-91     Citation Subset:  IM    
Affiliation:
Department of Surgery, National Taiwan University, Taipei.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures / adverse effects*
Child
Extracorporeal Membrane Oxygenation*
Female
Femoral Artery / physiology
Femoral Vein / physiology
Hemorrhage / prevention & control
Heparin / therapeutic use
Humans
Infant
Longitudinal Studies
Male
Middle Aged
Postoperative Complications / epidemiology,  therapy
Shock, Cardiogenic / mortality,  therapy*
Taiwan
Chemical
Reg. No./Substance:
9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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