ECMO as a Bridge to Reoperative Cardiac Surgery in a Patient with Cardiogenic Shock and Severe Aortic Insufficiency Due to an Acute Aortic Valve Homograft Failure

Unai, Shinya; Khullar, Vishal; Elgharably, H.; Navia, José L.

doi:10.1532/hsf.1758

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The use of ECMO should be considered at an early stage of treatment in a haemodynamically unstable patient after heart valve surgery if that patient has low systolic pressure, low cardiac output, and, as a consequence, insufficient tissue perfusion in which clinical stabilization is not achieved despite the use of conservative treatment in combination with the use of catecholamines [ 6 , 22 ]. The administration of oxygenated blood to the arterial system with appropriate kinetic energy, generated by the ECMO pump, ensures the adequate perfusion of peripheral tissues and relieves the heart muscle by promoting its regeneration [ 23 , 24 , 25 ]. Therefore, knowledge of the predictors of postoperative cardiogenic shock that do not respond to pharmacological treatment is extremely important because it enables the identification of patients at risk of this complication, thus enabling the early implementation of ECMO, which increases the patient’s chances of survival.…”

Section: Discussionmentioning

confidence: 99%

N-Terminal of the Prohormone Brain Natriuretic Peptide Predicts Postoperative Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation

Duchnowski

2022

JCM

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Aims: Heart valve surgery is associated with a risk of serious postoperative complications including postoperative cardiogenic shock (described as postcardiotomy shock (PCS)). The indication for extracorporeal membrane oxygenation (ECMO) is cardiogenic shock, which is resistant to optimal causal and pharmacological treatment, including the supply of catecholamines and/or an intra-aortic balloon pump (IABP). The aim of this study was to assess the usefulness of the selected preoperative biomarkers in the prediction of postoperative cardiogenic shock requiring ECMO in patients undergoing heart valve surgery. Methods: A prospective study was conducted on a group of consecutive patients with significant valvular heart disease that underwent elective valve surgery. The primary endpoint at the intra-hospital follow-up was postoperative cardiogenic shock requiring ECMO. Univariate analysis, followed by multivariate regression analysis, were performed. Results: The study included 610 patients. The primary endpoint occurred in 15 patients. At multivariate analysis, the preoperative N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) level (OR 1.022; 95% CI 1.011–1.034; p = 0.001) remained an independent predictor of the primary endpoint. Conclusions: An elevated NT-proBNP level was associated with a higher risk of postoperative cardiogenic shock requiring the use of ECMO.

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Section: Discussionmentioning

confidence: 99%

N-Terminal of the Prohormone Brain Natriuretic Peptide Predicts Postoperative Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation

Duchnowski

2022

JCM

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“…18 Acute Adult Respiratory Distress Syndrome as a sequela of trauma develops in approximately 4.6% of adult patients, with a mortality of up to 40% when managed with conventional ventilatory support. 14,17,[19][20][21] Adult Respiratory Distress Syndrome can also complicate the course of many acute care surgery pathologies, the most studied among them being acute pancreatitis, where it affects up to 30% of patients. 13 In patients with severe ARDS, there is a high mortality risk with conventional treatment.…”

Section: Discussionmentioning

confidence: 99%

Application and outcomes of extracorporeal life support in emergency general surgery and trauma

Brewer

Tran

et al. 2021

Perfusion

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Background: We analyzed the use of Extracorporeal Membranous Oxygenation (ECMO) in acute care surgery patients at our Level-1 trauma center. We hypothesized that this patient population has improved ECMO outcomes. Methods: This was a retrospective analysis of emergency general surgery and trauma patients placed on ECMO between the periods of October 2013 and February 2020. There were 10 surgical and 12 trauma patients studied, who eventually required ECMO support. ECMO support and ECMO type/modality were analyzed with injury and survival prognostic scores examined. Main results: Overall, 16 of the 22 patients survived to hospital discharge, for a survival rate of 73%. Mean age was 34.18 years. Mean hospital length of stay was 23.4 days with mean days on ECMO equal to 7.5. The net negative fluid balance was 5.36 L. Conclusions: The survival of our ECMO cohort is notably higher than previously cited studies. Our group demonstrated decreased length of time on ECMO, decreased length of stay in the hospital, and similar rates of complications compared to prior reports. ECMO is a useful modality in acute care surgical patients and should be considered in these patient populations. Our focus on net negative fluid balance for ECMO patients demonstrates improved survival. ECMO should be considered early in surgical patients and early in advanced trauma life support.

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Extracorporeal membrane oxygenation (ECMO) as bridge therapy to surgery in a patient with acute respiratory distress syndrome (ARDS) due to rupture of a pulmonary hydatid cyst

Gómez-Hernández

Martínez

Fuentes

et al. 2021

Archivos de Bronconeumología (English Edition)

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ECMO as a Bridge to Reoperative Cardiac Surgery in a Patient with Cardiogenic Shock and Severe Aortic Insufficiency Due to an Acute Aortic Valve Homograft Failure

Cited by 4 publications

References 3 publications

N-Terminal of the Prohormone Brain Natriuretic Peptide Predicts Postoperative Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation

N-Terminal of the Prohormone Brain Natriuretic Peptide Predicts Postoperative Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation

Application and outcomes of extracorporeal life support in emergency general surgery and trauma

Extracorporeal membrane oxygenation (ECMO) as bridge therapy to surgery in a patient with acute respiratory distress syndrome (ARDS) due to rupture of a pulmonary hydatid cyst

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