Document Detail


Percutaneous venoarterial extracorporeal membrane oxygenation for emergency mechanical circulatory support.
MedLine Citation:
PMID:  8959770     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this retrospective study we report our initial experience with percutaneous venoarterial extracorporeal membrane oxygenation in the emergency treatment of intractable cardiogenic shock or pulseless electrical activity. Between January 1994 and July 1995, percutaneous venoarterial extracorporeal membrane oxygenation was attempted in seven patients (pulseless electrical activity, five patients; cardiogenic shock, two patients). In two of the seven patients, efforts at arterial cannulation resulted in cannula perforation at the level of the iliac artery. In the remaining five patients, percutaneous venoarterial extracorporeal membrane oxygenation could be established and was maintained for 3-84 h. Major bleeding remained a common complication during extracorporeal membrane oxygenation despite the use of heparin-coated bypass circuits and was responsible for death during extracorporeal membrane oxygenation in one patient. The remaining four patients could be weaned from mechanical circulatory support within 24 h, two after surgical interventions (resection of right atrial tumor, heart transplantation), one after thrombolytic therapy. In one patient, cardiac function recovered spontaneously after 6 h on venoarterial extracorporeal membrane oxygenation. Three patients were discharged from hospital, two of them made a full recovery, one sustained severe hypoxic brain injury. A few patients with intractable cardiogenic shock or pulseless electrical activity can be resuscitated with the help of emergency percutaneous venoarterial extracorporeal membrane oxygenation. Emergency venoarterial extracorporeal membrane oxygenation is associated with a high rate of complications and its use should therefore be limited to selected patients with a rapidly correctable underlying cardiopulmonary pathology (anatomic, metabolic or hypothermic) who do not respond to conventional advanced cardiac life support.
Authors:
P Mair; C Hoermann; M Moertl; J Bonatti; C Falbesoner; D Balogh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  33     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-03-10     Completed Date:  1997-03-10     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  29-34     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck School of Medicine, Austria.
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MeSH Terms
Descriptor/Qualifier:
Emergencies
Extracorporeal Membrane Oxygenation / adverse effects,  methods*
Female
Heart Arrest / therapy*
Hemorrhage / etiology
Humans
Male
Middle Aged
Resuscitation / methods
Retrospective Studies
Shock, Cardiogenic / therapy*
Time Factors
Treatment Outcome

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


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