The utility of extracorporeal membrane oxygenation in patients with circulatory collapse by electrical storm.
Acute coronary syndrome
Electrical storm
Extracorporeal membrane oxygenation
Journal
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs
ISSN: 1619-0904
Titre abrégé: J Artif Organs
Pays: Japan
ID NLM: 9815648
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
09
07
2020
accepted:
23
11
2020
pubmed:
19
1
2021
medline:
25
8
2021
entrez:
18
1
2021
Statut:
ppublish
Résumé
In patients experiencing electrical storm, intensive care using extracorporeal membrane oxygenation (ECMO) is an efficient treatment to overcome a hemodynamically unstable condition. The aim of this study was to examine the utility of ECMO in patients with circulatory collapse by electrical storm. We retrospectively examined 17 consecutive patients receiving veno-arterial ECMO for electrical storm between January 2016 and December 2018 in our institution. We compared survivors (n = 11) and non-survivors (n = 6). Thirteen were weaned from ECMO, of whom 11 patients (64.7%) survived and were discharged from hospital, while 6 patients died (35.3%). In comparisons between survivors and non-survivors, blood pH before starting ECMO was significantly higher in survivors (pH 7.32) than in non-survivors (pH 6.89, p = 0.027). Blood lactate level was significantly lower in survivors (6.2 mmol/L) than in non-survivors (12.2 mmol/L, p = 0.044). Complications of hypoxic ischemic encephalopathy were found in 4 non-survivors (66.7%), compared to survivors (0%, p = 0.006). Durations of intensive care unit stay and hospital stay were significantly longer in survivors (271 h, 62 days) than in non-survivors (50 h, 3 days, respectively). Outcomes of treatment using ECMO in patients with circulatory collapse due to electrical storm proved satisfactory. Increases in blood lactate level and decreases in blood pH before starting ECMO were thought to be related to mortality due to suspected irreversible organ damage by hypoxia before ECMO.
Identifiants
pubmed: 33459912
doi: 10.1007/s10047-020-01233-5
pii: 10.1007/s10047-020-01233-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
407-411Informations de copyright
© 2021. The Japanese Society for Artificial Organs.
Références
Kowey PR, Levine JH, Scheinman MM, et al. Randomized, double-blind comparison of intravenous amiodarone and bretylium in the treatment of patients with recurrent, hemodynamically destabilizing ventricular tachycardia or fibrillation. The Intravenous Amiodarone Multicenter Investigators Group. Circulation. 1995;92:3255–63.
doi: 10.1161/01.CIR.92.11.3255
Sakamoto T, Morimura N, Atsumi T, et al. Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation in adults with out-of-hospital cardiac arrest: a prospective observational study. Resuscitation. 2014;85:762–8.
doi: 10.1016/j.resuscitation.2014.01.031
Thiagarajan RR, Barbaro RP, Paden ML, et al. Extracorporeal life support organization registry international report 2016. ASAIO J. 2017;63:60–7.
doi: 10.1097/MAT.0000000000000475
Siao FY, Chiu CC, Yen HH, et al. Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: Conventional cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation. Resuscitation. 2015;92:70–6.
doi: 10.1016/j.resuscitation.2015.04.016
Brunner ME, Siegenthaler N, Giraud R, et al. Extracorporeal membrane oxygenation support as bridge to recovery in a patient with electrical storm related cardiogenic shock. Am J Emerg Med. 2013;31:e1-6.
doi: 10.1016/j.ajem.2012.08.043
Cave DM, Gazmuri RJ, Otto CW, et al. Part 7: CPR techniques and devices: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S720–8.
doi: 10.1161/CIRCULATIONAHA.110.970970
Lorusso R, Barili F, Thiagarajan RR, et al. In-hospital neurologic complications in adult patients undergoing venoarterial extracorporeal membrane oxygenation: results from the Extracorporeal Life Support Organization Registry. Crit Care Med. 2016;44:e964–72.
doi: 10.1097/CCM.0000000000001865
Ücer E, Fredersdorf S, Endemann D, et al. A unique access for the ablation catheter to treat electrical storm in a patient with extracorporeal life support. Europace. 2014;16:299–302.
doi: 10.1093/europace/eut165
Mullner M, Sterz F, Laggner AN, et al. The association between blood lactate concentration on admission, duration of cardiac arrest, and functional neurological recovery in patients resuscitated from ventricular fibrillation. Intensive Care Med. 1997;23:1138–43.
doi: 10.1007/s001340050470