Program ECMO v krajské nemocnici bez kardiochirurgie
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F18%3A00006563" target="_blank" >RIV/27283933:_____/18:00006563 - isvavai.cz</a>
Result on the web
<a href="http://journals.sagepub.com/doi/pdf/10.1177/2048872617751067" target="_blank" >http://journals.sagepub.com/doi/pdf/10.1177/2048872617751067</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1177/2048872617751067" target="_blank" >10.1177/2048872617751067</a>
Alternative languages
Result language
angličtina
Original language name
Program ECMO v krajské nemocnici bez kardiochirurgie
Original language description
Introduction: Extracorporeal Membrane Oxygenation (ECMO) is a method of extracorporeal circulation with increasing use in patients with cardiogenic shock or refractory cardiac arrest. The presentation describes the 18-month results of ECMO in a regional hospital without cardiac surgery. Methods: Prospective register of all patients treated with ECMO since April 2015. Result: From April 2015 to August 2016, we implemented 15 ECMO implementations. All were provided in catarrhs under X-ray control by bifemoral approach. Patients with refractive cardiac arrest were resuscitated during LUCAS II. Circular priming was controlled by a CCU nurse without the presence of a perfusion agent at the same time as the insertion of the canullase by an invasive cardiologist. We've provided 15 connections. Indications were: 1 protected PCI stem of the left coronary artery, 7x cardiogenic shock with previous cardiac arrest, 3x refractive cardiac arrest, 3x cardiogenic shock without cardiac arrest and 1x refractive pulmonary failure. Etiology was 4x pulmonary embolism, 6x myocardial infarction with ST elevation, 1x dilated cardiomyopathy, 1x preutaneous coronary intervention of high risk patient, 1x aortic stenosis, 1 x nonSTEMI and 1x respiratory failure. Cannulation was 100% successful in all cases without technical complications or trauma with bleeding. 27% of patients required distal protection of leg ischemia. 20% of patients required intervention for disseminated coagulopathy. 9 (60%) patients gave successful weaning, the mean ECMO time was 6.6 /- 2.5 days. Only 2 patients were subsequently transferred to cardiac surgery. We found 30-day results in good neurological status (CPC 1 and 2) in 8 (53%) patients. Hospital mortality was 47% (3x refractive cardiac arrest, 1x pulmonary embolism, 2x heart failure, 1x multiorgan failure). Refractory cardiac arrest was 100% mortality, cardiogenic shock was 33%. Conclusion: We have provided 15 ECMO implementations in 18 months since the vital indication without any technical complications. 30 days of survival in good neurological outcome was 53%, successful weaning 60%. Our findings suggest the feasibility of ECMO in regional centers without cardiac surgery.
Czech name
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Czech description
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Classification
Type
O - Miscellaneous
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2018
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů