Evaluate the results of veno-arterial extracorporeal membrane oxygenation for cardiogenic shock patient

Tran Thanh Hoa , Nguyen Van Thuc, Ha Mai Huong, Vo Thi Ngoc Anh, Dao Xuan Dung, Dinh Hai Nam

Main Article Content

Abstract

Background: Although there are many advances in the diagnosis and resuscitation of patients with cardiogenic shock, the mortality rate is still high, especially for patients with cardiogenic shock due to complications of acute myocardial infarction, the mortality rate can be up to 50 - 70%. Objective: "Evaluate the effectiveness of clinical, subclinical and complications of V-A ECMO in patients with cardiogenic shock". Method: Retrospective analysis of patients diagnosed with cardiogenic shock supported by V-A ECMO revascularization from October 2018 and June 2020; Analyze the significance of V-A ECMO with the clinical outcome prognosis and and complications of V-A ECMO. Results: There were 23 patients hospitalized for cardiogenic shock, they have used the V-A ECMO. The mean age was 53,5±17,6, the minimum age was 13, the oldest was 76. The shortest hospital stay time was 3.5 day and the longest treatment time is 32 days. There were 15 patients alive, accounting for 65.2%, 8 patients died, accounting for 35.8%. The percentage of patients living in the group of myocarditis reached the highest rate. Common complications in patients supported by V-A ECMO are left ventricular volume overload and infection. Conclusion: V-A ECMO is a treatment option for life-threatening cardiogenic shock that has not responded to other therapies.

Article Details

References

1. Đào Xuân Cơ, Đồng Phú Khiêm, Nguyễn Mạnh Dũng (2016), "Kết quả áp dụng tim phổi nhân tạo trong điều trị bệnh nhân sốc tim do viêm cơ tim tại khoa Hồi sức tích cực Bệnh viện Bạch Mai", Tạp chí Y học Việt Nam(2), pp. 109-114.
2. Lê Nguyên hải Yến. 2018. Hiệu quả và biến chứng của kỹ thuật oxy hóa máu qua màng ngoài cơ thể phương thức động – tĩnh mạch (V-A ECMO) trong điều trị cứu vãn viêm cơ tim cấp.
3. Mai Văn Cường và cs. Nhận xét hiệu quả áp dụng kỹ thuật tim phổi nhân tạo điều trị bệnh nhân sốc tim nặng tại khoa hồi sức tích cực bệnh viện Bạch Mai. vnaccemt.org.vn. hội thảo chuyên đề ECMO 2015.
4. Shinya Unai, *Daizo Tanaka, †Nicholas Ruggiero, *Hitoshi Hirose, Nicholas, C. Cavarocchi. Acute Myocardial Infarction Complicated by Cardiogenic Shock: An Algorithm-Based Extracorporeal Membrane Oxygenation Program Can Improve Clinical Outcomes. ArtifificialOrgans20162015,40(3):261••(••):••––269••
5. A. Reshad Garan, MD; Koji Takeda, MD, PhD, Michael Salna, MD, John Vandenberge, BS; Darshan Doshi, MD, MS; Dimitri Karmpaliotis, MD, PhD, Ajay J. Kirtane, MD, SM; Hiroo Takayama, MD, PhD, Paul Kurlansky, MD. Prospective Comparison of a Percutaneous Ventricular Assist Device and Venoarterial Extracorporeal Membrane Oxygenation for Patients With Cardiogenic Shock Following Acute Myocardial Infarction. J Am Heart Assoc.2019;8:e012171
6. Hyungtae Kim, Sang-Hyun Lim, Joonhwa Hongc You-Sun Hong, Cheol Joo Lee, Joon-Ho Jung, Saehwan Yu. Efficacy of veno-arterial extracorporeal membrane oxygenation in acute myocardial infarction with cardiogenic shock. Resuscitation 83 (2012) 971– 975
7. Sheu JJ, Tsai TH, Lee FY et al (2010) Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicatedwithprofoundcardiogenicshock. Crit CareMed 38:1810–1817
8. Sakamoto S, Taniguchi N, Nakajima S, Takahashi A(2012) Extracorporeal life support for cardiogenic shock or cardiac arrest due to acute coronary syndrome. Ann Thorac Surg 94:1–7.
9. Tsao NW, Shih CM, Yeh JS et al (2012) Extracorporeal membrane oxygenation-assisted primary percutaneous coronary intervention may improve survival of patients with acute myocardial infarction complicated by profound cardiogenic shock. J Crit Care27(530):e1–e11.
10. Sattler S, Khaladj N, Zaruba MM et al (2014). Extracorporallifesupport (ECLS)inacuteischaemic cardiogenic shock. int J Clin Pract 68:529–531.
11. Leick J, Liebetrau C, Szardien S et al (2013). Door-to-implantation time of extracorporeal life support systems predicts mortality in patients with out-of-hospital cardiac arrest. Clin Res Cardiol 102:661–66
12. Stub D, Bernard S, Pellegrino V et al (2015). Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation 86:88–94
13. Sun Terri, MD, Guy Andrew, MD, Sidhu Amandeep, MSc, Finlayson Gordon, MD, Grunau Brian, MD MHSc, Ding Lillian, MSc, Harle Saida, BSc, Dewar Leith, MD, Cook Richard, MD, MSc, Kanji Hussein D.,MD, MSc MPH. Veno - arterial extracorporeal membrane oxygenation (VA-ECMO) for emergency cardiac support. Circulation: Heart Failure. 2018;11.