Outcomes of extracorporeal membrane oxygenation support in the cardiac catheterization laboratory.
Catheter Cardiovasc Interv
; 96(3): 547-555, 2020 09 01.
Article
em En
| MEDLINE
| ID: mdl-31486571
ABSTRACT
OBJECTIVES:
The aims of this single-center retrospective study were to characterize and determine predictors of 30-day survival in a cohort of patients requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO) supported cardiopulmonary resuscitation (E-CPR) in the cardiac catheterization laboratory (CCL) for cardiac arrest (CA) or refractory cardiogenic shock (CS).BACKGROUND:
While safety in the CCL has improved, periprocedural mortality from CA remains high. The application of VA-ECMO is an emerging form of resuscitation with a paucity of data evaluating its use in the CCL for CA or CS.METHODS:
All consecutive patients aged 18 years or older presenting to a single CCL from October 2010 to May 2018 who required E-CPR for CA or refractory CS were included. The primary outcome of our study was overall survival 30 days from VA-ECMO initiation. Secondary outcomes included 1-year survival, hospital length of stay, and ECMO related complications.RESULTS:
Sixty-two patients with a mean age of 60 ± 9 years, 63% male, were included. VA-ECMO was initiated for CA in 39 patients (63%) and for CS in 23 patients (37%). The median ECMO duration was 48 hr. Overall 30-day survival was 47% (CA group 44% vs. CS group 52%; p = .414). One-year survival was 44%. Initial serum creatinine (OR 1.18 per 10 µmol/L increase; p = .016; AUC = 0.65) was the only multivariate predictor of 30-day mortality.CONCLUSIONS:
The use of VA-ECMO in the CCL is feasible, demonstrating 47% 30-day survival, largely persistent to 1 year, in a cohort that otherwise has extremely high mortality.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Choque Cardiogênico
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Cateterismo Cardíaco
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Oxigenação por Membrana Extracorpórea
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Reanimação Cardiopulmonar
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Parada Cardíaca
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article