https://scholars.lib.ntu.edu.tw/handle/123456789/560327
標題: | Extracorporeal membranous oxygenation support for acute fulminant myocarditis: Analysis of a single center's experience | 作者: | Hsu K.-H. NAI-HSIN CHI HSI-YU YU CHIH-HSIEN WANG SHU-CHIEN HUANG SHOEI-SHEN WANG Ko W.-J. YIH-SHARNG CHEN |
公開日期: | 2011 | 卷: | 40 | 期: | 3 | 起(迄)頁: | 682-688 | 來源出版物: | European Journal of Cardio-thoracic Surgery | 摘要: | Objectives: Acute fulminant myocarditis (AFM) is a disease category that is easily neglected. Circulatory mechanical support is sometimes required for this devastating condition. We analyzed our experience in managing AFM with mechanical circulatory support. Methods: We applied extracorporeal membrane oxygenation (ECMO) as a first-line rescue for AFM. The diagnosis was mainly derived from clinical results and biopsy. Results: Seventy-five patients were enrolled in the age range of 29.6 ± 18.6 years and the pediatric group (<18 years) comprised 32% (n = 24) of our patient group. Thirty-five patients (47%) underwent cardiopulmonary resuscitation (CPR) before ECMO. The indication for ECMO included high inotropic support 69% (n = 54) and continuous CPR at ECMO setup 31% (n = 23). The ECMO duration was 171 ± 121. h. Survival to discharge was 64% (n = 48), 61% in adult group, and 70.8% in pediatric group. Six patients were later bridged to ventricular assist device use (5 left ventricular assist device (LVAD) and 1 bi-ventricular assist device (BVAD)) but three died of multiple-organ failure. Three patients (4%) underwent heart transplantation and all of them survived to discharge. Resuscitation did not have a significant factor for survival. Only two patients (3%) developed late mortality due to a cardiac event. Conclusions: AFM still carries high mortality rates in spite of advanced mechanical support. Most of the survivors did not require transplantation and could return to good lifestyle. Due to its simplicity and effectiveness, ECMO can be a first-line tool to rescue this group of patients. ? 2011 European Association for Cardio-Thoracic Surgery. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-80051562810&doi=10.1016%2fj.ejcts.2010.12.050&partnerID=40&md5=5a38d048735f0619ad841c5efa5455af https://scholars.lib.ntu.edu.tw/handle/123456789/560327 |
ISSN: | 1010-7940 | DOI: | 10.1016/j.ejcts.2010.12.050 | SDG/關鍵字: | acute fulminant myocarditis; adult; article; artificial ventilation; biventricular assist device; device; extracorporeal oxygenation; female; heart muscle biopsy; heart transplantation; hospital discharge; human; major clinical study; male; multiple organ failure; myocarditis; pediatrics; priority journal; resuscitation; survival; Acute Disease; Adolescent; Adult; Cerebrovascular Disorders; Child; Extracorporeal Membrane Oxygenation; Female; Follow-Up Studies; Heart Transplantation; Heart-Assist Devices; Humans; Male; Middle Aged; Myocarditis; Prognosis; Renal Dialysis; Renal Insufficiency; Retrospective Studies; Treatment Outcome |
顯示於: | 醫學系 |
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