Peak troponin predicts successful weaning from VA ECMO in patients with acute myocardial infarction complicated by cardiogenic shock.
Cardiac assist and artificial heart
ECMO
apheresis and detoxification techniques
artificial kidney
circulatory support
myocardial infarction
ventricular assist devices (VAD)
Journal
The International journal of artificial organs
ISSN: 1724-6040
Titre abrégé: Int J Artif Organs
Pays: United States
ID NLM: 7802649
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
pubmed:
4
2
2021
medline:
28
12
2021
entrez:
3
2
2021
Statut:
ppublish
Résumé
In patients treated for refractory cardiogenic shock (RCS) following acute myocardial infarction (AMI), predicting successful weaning from veno-arterial extracorporeal membrane oxygenation (VA ECMO) has important implications for decision-making and prognosis. We performed a retrospective review of adult VA ECMO patients with RCS complicating AMI at our institution from 2010 to 2019. We evaluated use of peak troponin I as a predictor of successful decannulation. Sixty-two patients were analyzed; mean age 61.1 ± 9.8 years, 73% males, 62% presented with STEMI. Forty-five patients were successfully weaned (group I). Seventeen patients did not wean (group II); seven patients received a durable LVAD, 10 died. Patients from group I had significantly lower peak troponin I (89 vs 434 ng/mL, Peak troponin I above 400 ng/mL may be helpful in predicting unsuccessful weaning from VA ECMO support for refractory cardiogenic shock following myocardial infarction and facilitate triage decisions regarding need for advanced therapies.
Sections du résumé
BACKGROUND
BACKGROUND
In patients treated for refractory cardiogenic shock (RCS) following acute myocardial infarction (AMI), predicting successful weaning from veno-arterial extracorporeal membrane oxygenation (VA ECMO) has important implications for decision-making and prognosis.
METHODS
METHODS
We performed a retrospective review of adult VA ECMO patients with RCS complicating AMI at our institution from 2010 to 2019. We evaluated use of peak troponin I as a predictor of successful decannulation.
RESULTS
RESULTS
Sixty-two patients were analyzed; mean age 61.1 ± 9.8 years, 73% males, 62% presented with STEMI. Forty-five patients were successfully weaned (group I). Seventeen patients did not wean (group II); seven patients received a durable LVAD, 10 died. Patients from group I had significantly lower peak troponin I (89 vs 434 ng/mL,
CONCLUSIONS
CONCLUSIONS
Peak troponin I above 400 ng/mL may be helpful in predicting unsuccessful weaning from VA ECMO support for refractory cardiogenic shock following myocardial infarction and facilitate triage decisions regarding need for advanced therapies.
Identifiants
pubmed: 33530814
doi: 10.1177/0391398821991155
doi:
Substances chimiques
Troponin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM