|Title:||Use of Extracorporeal Membrane Oxygenation to Rescue Patients With Refractory Ventricular Arrhythmia in Acute Myocardial Infarction||Authors:||CHIH-FAN YEH
|Keywords:||CARDIAC-ARREST; LIFE-SUPPORT; CARDIOPULMONARY-RESUSCITATION; CARDIOGENIC-SHOCK; FIBRILLATION; OUTCOMES; MANAGEMENT||Issue Date:||Jul-2015||Publisher:||LIPPINCOTT WILLIAMS & WILKINS||Journal Volume:||94||Journal Issue:||30||Start page/Pages:||e1241||Source:||Medicine||Abstract:||
Refractory ventricular arrhythmia is a serious problem in acute myocardial infarction (AMI), with an extremely high mortality rate and limited effective treatment. Extracorporeal membrane oxygenation (ECMO) is useful to rescue patients with cardiopulmonary collapse. However, little is known about whether ECMO is a potential rescue technique for patients with refractory ventricular arrhythmia in AMI.We retrospectively analyzed prospectively collected data on patients with AMI and refractory ventricular arrhythmia who underwent ECMO as rescue therapy and the bridge to revascularization from February 2001 to January 2013. Primary endpoint was mortality on index admission, and secondary endpoint was mortality on index admission or advanced brain damage at discharge.A total of 69 (62 men) patients were enrolled in this study. During the index admission, 39 patients (56.5%) met primary endpoint, and 45 patients (65.2%) met secondary endpoint, respectively. In multivariate Cox regression analysis, both the presence of profound anoxic encephalopathy and acute renal failure requiring dialysis were significant predictive factors for both primary and secondary endpoints.ECMO is a feasible rescue therapy and bridge to revascularization in patients with refractory ventricular arrhythmia in acute myocardial infarction. The presence of profound anoxic encephalopathy and acute renal failure requiring dialysis were significant prognostic factors.
creatine kinase MB; acute heart infarction; acute kidney failure; adult; Article; brain damage; brain disease; cardiovascular mortality; consciousness level; controlled study; coronary artery bypass graft; electrocardiography; emergency care; extracorporeal oxygenation; female; functional status; heart left bundle branch block; heart muscle revascularization; heart ventricle arrhythmia; hospital discharge; human; major clinical study; male; middle aged; outcome assessment; percutaneous coronary intervention; priority journal; resuscitation; retrospective study; return of spontaneous circulation; shock; ST segment elevation myocardial infarction; survival rate; survivor; complication; epidemiology; extracorporeal oxygenation; follow up; heart infarction; hospital admission; mortality; procedures; risk factor; Tachycardia, Ventricular; Taiwan; treatment outcome; trends; Extracorporeal Membrane Oxygenation; Female; Follow-Up Studies; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Infarction; Patient Admission; Retrospective Studies; Risk Factors; Survival Rate; Tachycardia, Ventricular; Taiwan; Treatment Outcome
|Appears in Collections:||醫學系|
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