Extracorporeal Membrane Oxygenation Support for Adult Post-Cardiotomy Cardiogenic Shock
Date Issued
2002
Date
2002
Author(s)
Ko, Wen-Je
DOI
902314B002428
Abstract
(n=4), and multiple organ failure (n=17). Twenty patients were weaned off ECMO support
and survived to hospital discharge. During the follow-up of 33±22 months, all were in
NYHA functional status I or II except two cases of late deaths. Among the ECMO-weaned
patients, “dialysis for acute renal failure” was a significant factor in reducing the chance of
survival.
Conclusions: ECMO provided a satisfactory partial cardiopulmonary support to patients
with PCS, and allowed time for clinicians to assess patients and make an appropriate
decision.
Subjects
extracorporeal membrane oxygenation
post-cardiotomy cardiogenic shock
intraaortic balloon pumping
ventricular assist device
myocardial stunning
Background. Post-cardiotomy cardiogenic shock (PCS) often inflicts post-cardiac surgical
patients. We report our experiences of using extracorporeal membrane oxygenation (ECMO)
in adult patients with PCS, and analyze the factors that affected outcomes for these ECMO
patients.
Methods. Retrospective review of medical records of the ECMO patients
Results. From Aug. 1994 to May 2000, 76 adult patients (48 male, 28 female
patients. We report our experiences of using extracorporeal membrane oxygenation (ECMO)
in adult patients with PCS, and analyze the factors that affected outcomes for these ECMO
patients.
Methods. Retrospective review of medical records of the ECMO patients
Results. From Aug. 1994 to May 2000, 76 adult patients (48 male, 28 female
mean
age:56.8±15.9 years) received ECMO support for PCS at the National Taiwan University
Hospital. The mean ECMO blood flow was 2.53±0.84 L/min. The cardiac operations
included coronary artery bypass grafting (n=37), coronary artery bypass grafting and
valvular surgery (n=6), valvular surgery alone (n=14), heart transplantation (n=12),
correction of congenital heart defects (n=3), implantation of a left ventricular assist device
(n=2), and aortic operations (n=2). Fifty-four patients received ECMO support after
intra-aortic balloon pumping, but 22 patients directly received ECMO support.
Two patients were bridged to heart transplantation and two bridged to ventricular
assist devices. Thirty patients died on ECMO support. The mortality etiologies included
brain death (n=3), refractory arrhythmia (n=2), near motionless heart (n=2), acute graft
rejection (n=1), primary graft failure (n=1), uncontrolled bleeding (n=5), and multiple
organ failure (n=16). Twenty-two patients were weaned off ECMO support but presented
intrahospital mortality. The mortality etiologies included brain death (n=1), sudden death
age:56.8±15.9 years) received ECMO support for PCS at the National Taiwan University
Hospital. The mean ECMO blood flow was 2.53±0.84 L/min. The cardiac operations
included coronary artery bypass grafting (n=37), coronary artery bypass grafting and
valvular surgery (n=6), valvular surgery alone (n=14), heart transplantation (n=12),
correction of congenital heart defects (n=3), implantation of a left ventricular assist device
(n=2), and aortic operations (n=2). Fifty-four patients received ECMO support after
intra-aortic balloon pumping, but 22 patients directly received ECMO support.
Two patients were bridged to heart transplantation and two bridged to ventricular
assist devices. Thirty patients died on ECMO support. The mortality etiologies included
brain death (n=3), refractory arrhythmia (n=2), near motionless heart (n=2), acute graft
rejection (n=1), primary graft failure (n=1), uncontrolled bleeding (n=5), and multiple
organ failure (n=16). Twenty-two patients were weaned off ECMO support but presented
intrahospital mortality. The mortality etiologies included brain death (n=1), sudden death
Publisher
臺北市：國立臺灣大學醫學院外科
Type
report
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