Application of extracorporeal membrane oxygenation in right ventricular failure after heart transplantation / 天津医药

ABSTRACT

Objective To summarize the value of extracorporeal membrane oxygenation (ECMO) in right ventricular failure after heart transplantation. Methods Data of 31 cases with orthotopic heart transplantations from January 2016 to January 2018, in Tianjin First Central Hospital were retrospectively analyzed. Three patients received ECMO support because of right ventricular failure after operation.There were two males and one female in these three patients.Their ages were 52,38 and 67 years old.ECMO was performed in the heart transplantation(2 patients)and eight hours after the surgery. ECMO was established in these patients via femoral artery and femoral vein,V-A model.The mean blood flow was about 3.0 L/min.Continuous ventilator supports,low temperature sedation,anti-infection and nutrition support therapy were applied in the ECMO procedure.Results ECMO was weaned off successfully in all three patients.The time for ECMO was(144-177) h. All three patients were treated with continuous renal replacement therapy (CRRT). One patient had renal failure, the transition was given to regular dialysis after CRRT treatment, and the regular dialysis treatment after discharged from hospital.The ventilator time was(168.6±24.6)h in the three patients.The duration of staying in the intensive care unit was (31.8 ± 12.5) d. All three patients were discharged from the hospital successfully, and their cardiac function was normal. Conclusion ECMO can be used to treat right heart failure after heart transplantation,and the clinical effect is satisfactory.