کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5967960 1576165 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
ECMO as a bridge to decision: Recovery, VAD, or heart transplantation?
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
ECMO as a bridge to decision: Recovery, VAD, or heart transplantation?
چکیده انگلیسی

BackgroundOur 8-year experience with ECMO support as a bridge to decision was reviewed.MethodsA cohort of 124 consecutive patients received ECMO for refractory cardiogenic shock in our institution. Twenty-six of these were out of hospital cardiac arrests and were excluded from this analysis. The median age was 43 years, in the range of 11 to 73 years.ResultsThe median duration of ECMO support was 4.5 days. Mortality while supported by ECMO was 50% with a median support time of 2 days. Weaning from ECMO was achieved for 49 patients with the following outcomes: cardiac recovery (60%), heart transplantation (26%), and VAD implantation (14%). Median duration of support before weaning was 8 days. Hospital survival was 83%, 61.5% and 71% for cardiac recovery, heart transplantation and VAD implantation, respectively. ECMO weaning was significantly improved in all patients who had normalized their renal function, and when duration of support > 6 days (HR: 4.255 [1.255-14.493], p = 0.02 and HR: 2.164 [1.152-4.082], p = 0.02, respectively). A creatinine level > 14 mg/l the day of weaning was a significant predictor of death (HR: 5.807 [1.089-30.953]; p = 0.04). Median follow up was 2.4 years; one-year survival rate was 78%, 51% and 75% for cardiac recovery, heart transplantation and VAD implantation, respectively.ConclusionWith at least 6 days of support, ECMO allowed a better patient selection for myocardial recovery, VAD implantation or heart transplantation. Whether VAD implantation or heart transplant in those patients is a better indication remains to be evaluated.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Cardiology - Volume 187, 6 May 2015, Pages 620-627
نویسندگان
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