Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation
Journal
Annals of Thoracic Surgery
Journal Volume
68
Journal Issue
6
Date Issued
1999-12-01
Author(s)
Lin, Fang Yue
Chu, Shu Hsun
Ko, Wen Je
Abstract
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.
SDGs
Other Subjects
adrenalin; creatine kinase MB; dobutamine; dopamine; heparin; immunoglobulin; immunoglobulin G; isoprenaline; milrinone; noradrenalin; troponin T; acute disease; adult; article; cardiogenic shock; child; clinical article; controlled study; extracorporeal oxygenation; female; heart failure; heart ventricle function; hemofiltration; human; male; multiple organ failure; myocarditis; priority journal; Acute Disease; Adolescent; Adult; Child; Creatine Kinase; Extracorporeal Membrane Oxygenation; Female; Humans; Immunoglobulins, Intravenous; Isoenzymes; Male; Myocarditis; Shock, Cardiogenic; Survival Rate; Troponin T
Type
journal article