Extracorporeal membrane oxygenation: Preliminary results in patients with postcardiotomy cardiogenic shock

Magovern, George J.; Magovern, James A.; Benckart, Daniel H.; Lazzara, Robert R.; Sakert, Tamara; Maher, Thomas D.; Clark, Richard E.

doi:10.1016/0003-4975(94)90101-5

Cited by 75 publications

(33 citation statements)

References 9 publications

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“…Therefore, PCPS has been wildly used for severe cardiac failure, cardiogenic shock, and/or postoperative cardiac support. [3][4][5] Recently, a heparin-coated PCPS circuit including centrifugal pump and membrane oxygenator has been established, and PCPS can be started easily and quickly with this circuit. However, some PCPS patients cannot be easily weaned from its support.…”

mentioning

confidence: 99%

Factors for Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Severe Cardiac Failure A Comparative Study in Weaned and Nonweaned Patients

et al. 2006

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SUMMARYThe percutaneous cardiopulmonary support system (PCPS) has been widely accepted for the treatment of patients with severe cardiac failure. This system, which uses Seldinger's method through a percutaneous approach, enables rapid application in emergency situations. However, the indication for deployment and discontinuation of PCPS has not yet been established. We evaluated the results of PCPS use for the treatment of patients with severe cardiac failure and investigated factors that would predict successful weaning from PCPS.A total of 32 patients (23 men and 9 women) who had PCPS for the treatment of severe cardiac failure between January 1997 and October 2004 were retrospectively reviewed. The mean age of the patients was 57 ± 17 years (range, 14 to 78 years). PCPS was necessary for severe cardiac failure after cardiac surgery in 15 patients, pulmonary infarction in 4, acute myocardial infarction in 3, acute myocarditis in 3, and other causes in 7.The mean duration of PCPS support in all 32 patients was 134 ± 117 hours (range, 8 to 532). Twelve patients (38%) could be weaned from PCPS (group A), while the remaining 20 patients (62%) could not (group B). The incidence of cardiac arrest prior to PCPS use (n = 10, 31%) was significantly (P < 0.05) lower in group A (1/12, 8%) than in group B (9/20, 45%). There were significant differences in the APACHE II scores, urine output, serum lactate levels, and epinephrine and dopamine dose received from PCPS induction to 72 hours after PCPS use between the 2 groups (P < 0.05). Multivariate logistic regression analysis showed that an episode of cardiac arrest prior to PCPS induction was the only significant predictor for the unsuitability for discontinuation of PCPS.This retrospective study showed the limitation of PCPS therapy for patients with an episode of cardiac arrest who did not show improvement in their APACHE II score, urine output, serum lactate levels, and catecholamine dose received within 72 hours after PCPS induction. These results may help formulate criteria for indication and discontinuation of From the

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confidence: 99%

Factors for Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Severe Cardiac Failure A Comparative Study in Weaned and Nonweaned Patients

et al. 2006

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“…These patients were routinely treated with ECMO to provide cardiac and respiratory support. The mortality rates among these patients have been reported to range from 50% to 70% 1,2,15–17 . Our patients showed one‐ and five‐year mortality rates of 80% and 83%, respectively.…”

Section: Discussionmentioning

confidence: 49%

Factors Predicting Early- and Long-Term Survival in Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO)

Lee

Chung

Lee

et al. 2012

Journal of Cardiac Surgery

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“…[18][19][20][21][22][23][24][25][26][27] Current techniques enable 44% of patients to survive to hospital discharge, and approximately 30% can be weaned from support directly. For those who cannot be weaned, ECMO can be used as a bridge to VAD placement or to heart transplantation.…”

Section: Discussionmentioning

confidence: 99%

A Case of Survival after Cardiac Arrest and 3½ Hours of Resuscitation

Nusbaum¹,

Bassett²,

Gregorič³

et al. 2014

Texas Heart Institute Journal

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I n general, outcomes after cardiac arrest remain poor, especially in patients with risk factors such as unwitnessed arrest, unfavorable initial rhythm, older age, and prolonged resuscitation without return of spontaneous circulation (ROSC). 1-4Guidelines therefore exist for terminating resuscitative efforts in cases of cardiac arrest that are deemed futile. 5,6 Nonetheless, successful resuscitation and good recovery after prolonged arrest have been documented. [7][8][9][10] As the field of cardiopulmonary resuscitative medicine evolves, new techniques are being implemented to improve outcomes in patients who are in cardiac arrest. We present an example of how recent research findings in resuscitative medicine improved one patient's chances of survival. Case ReportIn June 2011, a 40-year-old white man with a history of hypertension, hyperlipidemia, obesity (body mass index, 34.9 kg/m 2 ), and chronic tobacco use presented with presyncopal symptoms. Severe pressure-like chest pain had started 24 hours previously and had completely resolved spontaneously 12 hours before the current presentation. An electrocardiogram (ECG) showed persistent ST-segment elevation in the anterior leads. He was hemodynamically well compensated. Initial laboratory reports showed cardiac troponin I elevation to a level above 50 ng/mL.The patient was not a candidate for primary percutaneous coronary intervention (PCI) for STEMI because of his delayed presentation, the complete resolution of his chest pain, and the development of anterior Q waves on his ECG. He was admitted to the cardiovascular care unit (CCU) and was treated conservatively with antiplatelet, anticoagulant, and antiarrhythmic therapy.The next morning, a coronary angiogram revealed an occluded proximal left anterior descending coronary artery, an occluded obtuse marginal branch, and a diffusely diseased right coronary artery. On hospital day 3, a positron emission tomographic viability scan showed only minimal viable myocardium and a large area of scar tissue; therefore, the patient was not a candidate for revascularization. He remained hemodynamically stable in the CCU and was subsequently transferred to the medicine floor.At 5:37 am on hospital day 5, the patient experienced sustained ventricular tachycardia and then lost consciousness. He had no spontaneous respirations, and neither the carotid nor femoral pulses could be palpated. His airway was secured, and positive-pressure ventilation was initiated. Simultaneously, cardiopulmonary resuscita-

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Extracorporeal membrane oxygenation: Preliminary results in patients with postcardiotomy cardiogenic shock

Cited by 75 publications

References 9 publications

Factors for Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Severe Cardiac Failure A Comparative Study in Weaned and Nonweaned Patients

Factors for Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Severe Cardiac Failure A Comparative Study in Weaned and Nonweaned Patients

Factors Predicting Early- and Long-Term Survival in Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO)

A Case of Survival after Cardiac Arrest and 3½ Hours of Resuscitation

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