Central extracorporeal life support with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure

Journal of Cardiothoracic Surgery

Arjang Ruhparwar¹  Matthias Karck¹  Andre Ruediger Simon⁵  Aron Frederik Popov⁴  Jens Roggenbach²  Ursula Tochtermann¹  Markus Verch¹  Rawa Arif¹  Philipp Raake³  Christopher T Bowles⁵  Anton Sabashnikov⁵  Bastian Schmack¹  Alexander Weymann¹ 

[1] Department of Cardiac Surgery, Heart Center - University of Heidelberg, INF 110, 69120 Heidelberg, Germany;Department of Anesthesiology, University of Heidelberg, INF 110, 69120 Heidelberg, Germany;Department of Cardiology, Angiology and Pulmonology, Heart Center – University of Heidelberg, INF 410, 69120 Heidelberg, Germany;Department of Thoracic and Cardiovascular Surgery, University Hospital Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany;Department of Cardiothoracic Transplantation & Mechanical Circulatory Support, Royal Brompton and Harefield NHS Foundation Trust, Hill End Road, Harefield, Middlesex, UB9 6JH London, UK

关键词: Extracorporeal life support;    Lung failure;    Cardiogenic shock;    Mechanical circulatory support;   

Others  :  811033
DOI  :  10.1186/1749-8090-9-60

 received in 2014-01-13, accepted in 2014-03-24,  发布年份 2014

【 摘 要 】

Background

The purpose of this prospective study was to evaluate the effects and functional outcome of central extracorporeal life support (ECLS) with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure.

Methods

Between August 2010 and August 2013, 12 consecutive patients (2 female) with a mean age of 31.6 ± 15.1 years received central ECLS with left ventricular decompression for the treatment of refractory cardiogenic shock and lung failure. Underlying disease was acute cardiac decompensation due to dilated cardiomyopathy (n = 3, 25%), coronary artery disease with acute myocardial infarction (AMI) (n = 3, 25%), and acute myocarditis (n = 6, 50%). We routinely implemented ECLS by cannulating the ascending aorta, right atrium and inserting a left ventricular decompression cannula vent via the right superior pulmonary vein.

Results

All patients were successfully bridged to either recovery (n = 3, 25%), long-term biventricular support (n = 6, 50%) or cardiac transplantation (n = 3, 25%). Seven patients (58.3%) were discharged after a mean hospital stay of 42 ± 11.9 days. The overall survival from ECLS implantation to the end of the study was 58.3%. The cumulative ICU stay was 23.1 ± 9.6 days. The length of support was 8.0 ± 4.3 days (range 3-17 days).

Conclusions

We strongly recommend left ventricular decompression in refractory cardiogenic shock and lung failure to avoid pulmonary edema, left heart distension and facilitate myocardial recovery.

【 授权许可】

   
2014 Weymann et al.; licensee BioMed Central Ltd.

【 图 表 】

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