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Titolo:
When to discontinue extracorporeal membrane oxygenation for postcardiotomysupport
Autore:
Fiser, SM; Tribble, CG; Kaza, AK; Long, SM; Zacour, RK; Kern, JA; Kron, IL;
Indirizzi:
Univ Virginia, Hlth Sci Ctr, Dept Thorac & Cardiovasc Surg, Charlottesville, VA 22908 USA Univ Virginia Charlottesville VA USA 22908 Charlottesville, VA 22908 USA
Titolo Testata:
ANNALS OF THORACIC SURGERY
fascicolo: 1, volume: 71, anno: 2001,
pagine: 210 - 214
SICI:
0003-4975(200101)71:1<210:WTDEMO>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
PULMONARY VASCULAR-RESISTANCE; CARDIAC TRANSPLANTATION; HEART-TRANSPLANTATION; CARDIOGENIC-SHOCK; PATIENT SELECTION; HYPERTENSION; REVERSIBILITY; PREDICTORS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Kron, IL Univ Virginia, Hlth Sci Ctr, Dept Thorac & Cardiovasc Surg, Box 3111,MR4 Bldg, Charlottesville, VA 22908 USA Univ Virginia Box 3111,MR4 BldgCharlottesville VA USA 22908 USA
Citazione:
S.M. Fiser et al., "When to discontinue extracorporeal membrane oxygenation for postcardiotomysupport", ANN THORAC, 71(1), 2001, pp. 210-214

Abstract

Background. Extracorporeal membrane oxygenation (ECMO) has demonstrated limited success in adult postcardiotomy shock. The goal of this study was to determine when to discontinue ECMO for postcardiotomy support. Methods. During a 7-year period ECMO was used in 51 postcardiotomy patients, of whom 16 (31%) weaned and 8 (16%) survived. Results. Patients in the heart transplant group were more likely to wean compared with patients in the non-heart transplant group (p = 0.03). Patients aged greater than 65 years (p = 0.04) or with ejection fractions of less than 30% after 48 hours of ECMO (p < 0.001) were less likely to wean. Time on ECMO was significantly longer for survivors in the heart transplant group (101.3 +/- 7.5 hours) compared with survivors in the non-heart transplantgroup (28.3 +/- 11.9 hours, p < 0.001). Conclusions. After 48 to 72 hours, consideration should be given to discontinuing ECMO, either by moving to an implantable ventricular assist device or by withdrawal of support, except in those patients with heart transplants. In the latter, both severe postoperative pulmonary hypertension and reperfusion injury may take as long as 120 hours to reverse. (Ann Thorac Surg 2001;71:210-4) (C) 2001 by The Society of Thoracic Surgeons.

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Documento generato il 26/01/20 alle ore 10:17:26