التفاصيل البيبلوغرافية
| العنوان: |
Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock post-cardiac arrest. |
| المؤلفون: |
de Chambrun, Marc Pineton1,2 (AUTHOR), Bréchot, Nicolas1,2 (AUTHOR), Lebreton, Guillaume3 (AUTHOR), Schmidt, Matthieu1,2 (AUTHOR), Hekimian, Guillaume1,2 (AUTHOR), Demondion, Pierre3 (AUTHOR), Trouillet, Jean-Louis1,2 (AUTHOR), Leprince, Pascal3 (AUTHOR), Chastre, Jean1,2 (AUTHOR), Combes, Alain1,2 (AUTHOR), Luyt, Charles-Edouard1,2 (AUTHOR), Pineton de Chambrun, Marc1,2 (AUTHOR) |
| المصدر: |
Intensive Care Medicine. Dec2016, Vol. 42 Issue 12, p1999-2007. 9p. |
| مصطلحات موضوعية: |
*CARDIOGENIC shock, *EXTRACORPOREAL membrane oxygenation, *CARDIAC arrest, *CARDIOPULMONARY resuscitation, *INTENSIVE care units, *THERAPEUTICS |
| مستخلص: |
Purpose: To describe the characteristics, outcomes, and risk factors associated with poor outcome of venoarterial extracorporeal membrane oxygenation (VA-ECMO)-treated patients with refractory shock post-cardiac arrest.Methods: We retrospectively analyzed data collected prospectively (March 2007-January 2015) in a 26-bed tertiary hospital intensive care unit. All patients implanted with VA-ECMO for refractory cardiogenic shock after successful resuscitation from cardiac arrest were included. Refractory cardiac arrest patients, given VA-ECMO under cardiopulmonary resuscitation, were excluded.Results: Ninety-four patients received VA-ECMO for refractory shock post-cardiac arrest. Their hospital and 12-month survival rates were 28 and 27 %, respectively. All 1-year survivors were cerebral performance category 1. Multivariable analysis retained INR >2.4 (OR 4.9; 95 % CI 1.4-17.2), admission SOFA score >14 (OR 5.3; 95 % CI 1.7-16.5), and shockable rhythm (OR 0.3; 95 % CI 0.1-0.9) as independent predictors of hospital mortality, but not SAPS II, out-of-hospital cardiac arrest score, or other cardiac arrest variables. Only 10 % of patients with an admission SOFA score >14 survived, whereas 50 % of those with scores ≤14 were alive at 1 year. Restricting the analysis to the 67 patients with out-of-hospital cardiac arrest of coronary cause yielded similar results.Conclusion: Among 94 patients implanted with VA-ECMO for refractory cardiogenic shock post-cardiac arrest resuscitation, the 24 (27 %) 1-year survivors had good neurological outcomes, but survival was significantly better for patients with admission SOFA scores <14, shockable rhythm, and INR ≤2.4. VA-ECMO might be considered a rescue therapy for patients with refractory cardiogenic shock post-cardiac arrest resuscitation. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
