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Rivista sulle Malattie del Cuore e dei Vasi
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2016 April;64(2):121-6
Safety research of extracorporeal membrane oxygenation treatment on cardiogenic shock: a multicenter clinical study
Guiying HOU 1, Kaijiang YU 1, Xinhua YIN 2, Hongliang WANG 1, Weijiang XU 3, Zhongtao DU 4, Xiaotong HOU 4, Yun LONG 5, Huan CHEN 5, Lei XU 6, Songqiao LIU 7 ✉
1 Intensive Care Unit, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, China; 2 Department of Cardiology, The 1st Affiliated Hospital of Harbin Medical University, Harbin, China; 3 Intensive Care Unit, Wuhan Asia Heart Hospital, Wuhan, China; 4 Intensive Care Unit, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing, China; 5 Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China; 6 Intensive Care Unit, Tianjin Third Central Hospital, Tianjin, China; 7 Intensive Care Unit, Zhongda Hospital, Southeast University, Nanjing, China
BACKGROUND: Study the survival rate of extracorporeal membrane oxygenation (ECMO) and control group to treat cardiogenic shock and the complication and safety of the ECMO.
METHODS: We collected patients with cardiogenic shock in the ICU of six hospitals from March 2013 to November 2014. There were 29 cases in the ECMO treatment group and 28 cases in the control group. The survival rate between ECMO treatment group and control group for 30 days and the occurrence rate of complication in the ECMO treatment group were compared.
RESULTS: For the 29 patients in the ECMO group, 11 patients survived (with a survival rate of 37.9%) for 30 days, and 18 patients died (with a mortality rate of 62.1%). For the 28 patients in the control group, three patients survived (with a survival rate of 10.7%) and 25 patients died (with a mortality rate of 89.3%). Fifteen patients succeeded in separating from the ECMO machine within 14 days in the ECMO group. There were 11 patients that survived and left the hospital, with the time of 272.91±397.98 hours on ECMO, and 14 patients could not separate from the machine and died. For complications in the ECMO group, 11 patients had hemorrhaging (37.93%), 5 patients with neurological complications (17.21%), 1 patient with pneumothorax (3.44%), 8 patients with renal failure (27.59%), 12 patients with heart complication (41.38%), 9 patients with infection (31.03%), 7 patients with hyperbilirubinemia (24.14%). Twenty nine patients on the ECMO all used ventilator for support, among which, 17 patients adopted intra-aortic balloon pump (IABP) simultaneously, 8 patients with continuous hemofiltration due to renal failure (27.59%), for the death patients in ECMO group, 12 patients died from cardiogenic shock (48%), 3 patients with brain death (12%), 2 patients with septic shock (8%), and one patient with multiple organ failure (4%).
CONCLUSIONS: The ECMO treatment can decrease the mortality rate with a low occurrence rate of complication, effective to rescue cardiogenic shock.