초록접수 현황
| 17F-247 | 포스터 발표 |
Modification of Extracorporeal Membrane Oxygenation Configuration according to Patient Status during ECMO Support
Jung Wook Han, Ho Sung Son, Jae Seung Jung
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Purpose : Extracorporeal membrane oxygenation (ECMO) configuration may not be fixed but be changed depending on the patient’s clinical condition. Also more complex ECMO configurations may be needed in some cases. We reviewed our experience in patients who received ECMO support, then converted to another ECMO configuration.
Methods : Among 233 patients who required ECMO support at our institution between January 2009 and July 2017, 20 patients (mean age : 53.3±16.2 years, 14 men and 6 women) were enrolled in this study. We retrospectively analyzed their clinical data and outcomes from electronic medical record.
Results : ECMO indication included acute respiratory distress syndrome (n=7), acute coronary syndrome (n=7), sepsis (n=3), pulmonary embolism (n=2) and arrhythmia (n=1). Nine patients underwent ECMO on the purpose of extracorporeal cardiopulmonary resuscitation. The Initial ECMO configurations were veno-arterial (V-A) (n=14), veno-venous (V-V) (n=5) and venovenous-arterial (VV-A) (n=1). There were seven patients (35%) who needed change in ECMO configuration more than two times. Reasons for conversion were differential hypoxia (n=9), no more needed atrial or venous cannulation (n=6), hemodynamic deterioration (n=5), left cardiac chamber dilatation needs venting (n=5) and inadequate drainage to maintain proper ECMO flow (n=4). Weaning rate was 30% (6/20) and three patients (15%) survived to hospital discharge.
Conclusion : Although careful assessment of patient’s condition and an appropriate conversion to ECMO configuration is important to patient survival, we did not find survival advantage in this study.
Methods : Among 233 patients who required ECMO support at our institution between January 2009 and July 2017, 20 patients (mean age : 53.3±16.2 years, 14 men and 6 women) were enrolled in this study. We retrospectively analyzed their clinical data and outcomes from electronic medical record.
Results : ECMO indication included acute respiratory distress syndrome (n=7), acute coronary syndrome (n=7), sepsis (n=3), pulmonary embolism (n=2) and arrhythmia (n=1). Nine patients underwent ECMO on the purpose of extracorporeal cardiopulmonary resuscitation. The Initial ECMO configurations were veno-arterial (V-A) (n=14), veno-venous (V-V) (n=5) and venovenous-arterial (VV-A) (n=1). There were seven patients (35%) who needed change in ECMO configuration more than two times. Reasons for conversion were differential hypoxia (n=9), no more needed atrial or venous cannulation (n=6), hemodynamic deterioration (n=5), left cardiac chamber dilatation needs venting (n=5) and inadequate drainage to maintain proper ECMO flow (n=4). Weaning rate was 30% (6/20) and three patients (15%) survived to hospital discharge.
Conclusion : Although careful assessment of patient’s condition and an appropriate conversion to ECMO configuration is important to patient survival, we did not find survival advantage in this study.
책임저자: Jae Seung Jung
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
발표자: Jung Wook Han, E-mail : irene962063@naver.com