Document Detail


Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation.
MedLine Citation:
PMID:  10617006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute myocarditis (AM) complicated with refractory cardiogenic shock carries a very high mortality. We report our experience in treating these patients, who were rescued by extracorporeal membrane oxygenation (ECMO) and intravenous immunoglobulin. METHODS: Over a 5-year period, 5 patients with AM were rescued with ECMO in our hospital. Femoral venoarterial ECMO was performed in 4 patients, and right atrium-left atrium-aorta ECMO in the other 1 due to ventricular dysfunction. Hemofiltration was applied to 3 patients. Marked elevated creatine kinase, its MB form, and troponin T (TnT) were found before ECMO. RESULTS: All the patients could be weaned off the ECMO after 140.0+/-57.7 hours of ECMO support. One patient died of multiple organ failure 10 days later after removal of ECMO, resulting in a 20% mortality. Renal function returned to normal in all survivors. The 4 survivors were discharged uneventfully in 23.3+/-8.3 days and resumed functional class I status. The TnT level declined to the low level within 3 days (slope -4.94+/-1.18 ng/mL/day), and might be an indicator of good recovery of myocardium. CONCLUSIONS: ECMO can provide an effective and simple treatment for critical AM with a satisfactory result and reduce the possibility of progressive cardiomyopathy.
Authors:
Y S Chen; M J Wang; N K Chou; Y Y Han; I S Chiu; F Y Lin; S H Chu; W J Ko
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  68     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-01-13     Completed Date:  2000-01-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2220-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, National Taiwan University Hospital, Taipei.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Child
Creatine Kinase / blood
Extracorporeal Membrane Oxygenation*
Female
Humans
Immunoglobulins, Intravenous / therapeutic use
Isoenzymes
Male
Myocarditis / blood,  complications,  mortality,  therapy*
Shock, Cardiogenic / etiology*
Survival Rate
Troponin T / blood
Chemical
Reg. No./Substance:
0/Immunoglobulins, Intravenous; 0/Isoenzymes; 0/Troponin T; EC 2.7.3.2/Creatine Kinase

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


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