Predictors for myocardial recovery of patients implanted with an ECMO device following myocardial infarction - 05/01/18

Résumé |
Introduction |
Extracorporeal membrane oxygenation (ECMO) has become the most widely used circulatory aid in refractory cardiogenic shock (CS). There is little data available on the predictive markers of a favorable outcome following myocardial infarction.
Objective |
To identify the factors predictive of the successful withdrawal of ECMO implanted for refractory CS of ischemic origin.
Methods |
This was an observational retrospective single-center study. The patients were distributed into two groups: successful (55%) or non successful (45%) ECMO weaning.
Results |
Sixty-five patients were included between January 2008 and March 2017 in the Poitiers University Hospital (CHU). Complete coronary revascularisation was achieved mainly in the in the “successful weaning” group, P=0.058. The 30-day survival rate was 43%. A history of myocardial infarction, [0.03–0.92, P=0.039], initial ventricular rhythm disorders (RD) [1.33–19.17, P=0.018] and the hemoglobin level [0.58–0.96, P=0.021] were revealed as independent predictive factors for successful weaning from ECMO.
Conclusion |
The early use of ECMO is an effective rescue strategy which provides recovery of myocardial function in close to 55% of cases. The occurrence of de ventricular RD (OR=5) on admission is predictive of greater survival.
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Vol 10 - N° 1
P. 152 - janvier 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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