Extracorporeal membrane oxygenation in the peri-operative period of heart transplantation / 中华心血管病杂志
Chinese Journal of Cardiology
;
(12): 1014-1017, 2009.
Artigo
em Chinês
| WPRIM
| ID: wpr-323947
ABSTRACT
<p><b>OBJECTIVE</b>To summarize and analyze clinical outcomes and experience about using extracorporeal membrane oxygenation (ECMO) in supporting heart transplant patients in the peri-operative period of in Fuwai Hospital retrospectively.</p><p><b>METHODS</b>We performed 131 orthotopic heart transplantations from June 2004 to December 2008. Fourteen cases used veno-artery ECMO (Medtronic Ltd) for mechanical circulatory support in the peri-operative period of heart transplantation. Active clotting time(ACT) was maintained between 160 - 200 seconds, mean blood flow was 1.8 - 3.3 L/min during ECMO assistant period.</p><p><b>RESULTS</b>Twelve survivals discharged with NYHAI, two patients died of multiple orgen failure with severe infection and complication of central nervous system. The ECMO time was 75 - 824 h and mean time 149 h. 12 survivals with ECMO assistance decreases the dose of vasoactive drugs, after bedside UCG evaluating heart function recovery with stable circulation, ECMO could be weaned off uneventfully after 100 h. Five patients with seven times bleeding complication and one patient with catheter-associated arterial thrombosis of distal limb, all ECMO patients with low-albuminemia and hyperbilirubinemia at some degree, eleven patients with increasing blood creatine and five patients were treated with continous renal replacement therapy, one patient with pertinacious hyperbilirubinemia was treated with plasma exchange and molecular absorbent recirculating system. Seven patients were extension incision healing and six patients were tracheotomy.</p><p><b>CONCLUSIONS</b>ECMO can bridge patients with end-stage heart failure to heart transplant, and extend the use of marginal donors, grasp the ECMO indication and timing of application, avoiding irreversible dysfunction of the vital organs and preventing complication during ECMO, ECMO may decrease mortality of severe patients in the peri-operative period of heart transplantation.</p>
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Terapêutica
/
Oxigenação por Membrana Extracorpórea
/
Estudos Retrospectivos
/
Mortalidade
/
Transplante de Coração
/
Resultado do Tratamento
/
Mortalidade Hospitalar
/
Assistência Perioperatória
/
Insuficiência Cardíaca
/
Métodos
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Chinês
Revista:
Chinese Journal of Cardiology
Ano de publicação:
2009
Tipo de documento:
Artigo
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