Outcome of Patients With Profound Cardiogenic Shock After Cardiopulmonary Resuscitation and Prompt Extracorporeal Membrane Oxygenation Support: A Single-Center Observational Study

Background: The in-hospital outcome of patients with profound cardiogenic shock (CS) undergoing extracorporeal membrane oxygenation (ECMO) and prognostic predictors were analyzed. Methods and Results: Between 2003 and 2010, 134 patients with profound CS undergoing 10-15min of cardiopulmonary cerebra...

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Bibliographic Details
Published in:Circulation Journal 2012, Vol.76(6), pp.1385-1392
Main Authors: Chung, Sheng-Ying, Sheu, Jiunn-Jye, Lin, Ying-Jui, Sun, Cheuk-Kwan, Chang, Li-Teh, Chen, Yung-Lung, Tsai, Tzu-Hsien, Chen, Chien-Jen, Yang, Cheng-Hsu, Hang, Chi-Ling, Leu, Steve, Wu, Chiung-Jen, Lee, Fan-Yen, Yip, Hon-Kan
Format: Article
Language:English
Subjects:
Adult
Aged
APACHE
Cardiopulmonary cerebral resuscitation
Cardiopulmonary Resuscitation - adverse effects
Cardiopulmonary Resuscitation - mortality
Extracorporeal Membrane Oxygenation - adverse effects
Extracorporeal Membrane Oxygenation - mortality
Extracorporeal membrane oxygenation support
Female
Hospital Mortality
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Profound cardiogenic shock
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Shock, Cardiogenic - diagnosis
Shock, Cardiogenic - mortality
Shock, Cardiogenic - therapy
Survival Rate
Taiwan
Time Factors
Treatment Outcome
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Summary:Background: The in-hospital outcome of patients with profound cardiogenic shock (CS) undergoing extracorporeal membrane oxygenation (ECMO) and prognostic predictors were analyzed. Methods and Results: Between 2003 and 2010, 134 patients with profound CS undergoing 10-15min of cardiopulmonary cerebral resuscitation (CPCR) and ECMO were prospectively recruited, including 27.6% (37) with ST-elevation myocardial infarction (STEMI), 11.9% (16) with non-STEMI, 22.4% (30) with post-surgery pump failure, 10.5% (14) with refractory congestive heart failure, 19.4% (26) with fulminant acute myocarditis, 2.2% (3) with pediatric congenital diaphragmatic hernia, and 6.0% (8) with percutaneous coronary intervention-related complications. The mean systolic pressure was 49.8mmHg and 91.8% of patients required ventilatory support prior to ECMO. The Post-ECMO Mean Acute Physiology and Chronic Health Evaluation (APACHE) II score and peak creatine kinase level were 26.2 and 5,311IU/L, respectively. In-hospital mortality was 57.5%. Sixty-eight patients (50.7%) were successfully weaned from ECMO and 57 (42.5%) were discharged alive. Univariate analysis identified the APACHE II score as the strongest predictor of in-hospital mortality (P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-11-1015