In:
ASAIO Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 66, No. 2 ( 2020-02), p. 146-152
Abstract:
Pulmonary Embolism (PE) is a common illness in western countries. The purpose of this study is to report the institutional experience with massive PE and Extracorporeal Membrane Oxygenation (ECMO) in inoperable patients on admission. A retrospective analysis using the institutional ECMO-registry including the time between 2006 and 2017 was performed. During the study period, 75 patients ( n = 46 patients venoarterial [VA], n = 29 patients venovenous [VV]) were placed on ECMO for massive PE. The primary support for massive PE consists of VA; however, VV support can be applied as well in selected cases as this work demonstrates. In the VA group, more patients (38 vs. 83%, P = 0.001) required mechanical resuscitation whereas in the VV group a more aggressive ventilation before support was noted ( e.g. minute ventilation: VA=8.8 ± 3.7 L/min, VV=11.5 ± 4.5 L/min, P = 0.01). Survival to discharge was similar in VV and VA patients (45 vs. 48%, P = 0.9). Patients who received additional therapeutic interventions after stabilization with ECMO – e.g. surgical thrombectomy – displayed a similar survival compared with those being only anticoagulated (44% vs. 49%, P = 0.40). ECMO is feasible for initial stabilization serving as a bridge to therapy in primarily inoperable patients with massive PE. The principal configuration of support is VA; however, VV can be applied as well in selected hemodynamically compromised cases under aggressive ventilation.
Type of Medium:
Online Resource
ISSN:
1058-2916
DOI:
10.1097/MAT.0000000000000953
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2083312-X
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