Program ECMO v krajské nemocnici bez kardiochirurgie

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Program ECMO v krajské nemocnici bez kardiochirurgie

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Program ECMO v krajské nemocnici bez kardiochirurgie

Popis výsledku anglicky

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.

Druh

O - Ostatní výsledky

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů