https://scholars.lib.ntu.edu.tw/handle/123456789/192253
標題: | Extracorporeal Membrane Oxygenation Support for Adult Post-Cardiotomy Cardiogenic Shock | 作者: | 柯文哲 Ko, Wen-Je |
關鍵字: | 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;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 | 公開日期: | 2002 | 出版社: | 臺北市:國立臺灣大學醫學院外科 | 摘要: | (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. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/24478 | 其他識別: | 902314B002428 | Rights: | 國立臺灣大學醫學院外科 |
顯示於: | 醫學系 |
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