Extracorporeal Membrane Oxygenation after Cardiac Surgery: A Clinical Analysis of 27 Adult Patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FANGYi-tan ,  GUTian-xiang , YULei

Department of Cardiovascular Surgery, The First Hospital Affiliated to China Medical University, Shenyang 110001, P.R.China;

Corresponding author：

GUTian-xiang, Email: cmugtx@sina.com

Keywords：

Cardiac surgery; Extracorporeal membrane oxygenation; Complications; Monitoring

DOI：

10.7507/1007-4848.20160140

Video：

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Objective To summarize the experience of applying extracorporeal membrane oxygenation (ECMO) after cardiac surgery in adult patient. Methods We retrospectively analyzed the clinical data of 27 patients underwent ECMO from December 2011 to October 2013. There were 15 males and 12 females at the mean age of 51±11 years ranging from 41 to 73 years. Vein-artery perfusion was performed in all 27 patients. Results All 27 patients underwent ECMO. The mean time of using ECMO was 81.2±36.4 hours ranging from 48.0-192.0 hours. The mean time of hospital stay was 307.8±97.0 hours ranging from 168.0-480.0 hours. The rate of weaning from ECMO was 77.8% (21/27). The rate of discharge was 51.9% (14/27). The rate of perioperative mortality was 44.4% (12/27). Conclusion Effective monitoring with other supportive equipments is helpful to promote the result of ECMO.

Citation： FANGYi-tan, GUTian-xiang, YULei. Extracorporeal Membrane Oxygenation after Cardiac Surgery: A Clinical Analysis of 27 Adult Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(6): 586-588. doi: 10.7507/1007-4848.20160140 Copy

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2.	Marasco SF, Lukas G, McDonald M, et al. Review of ECMO(extra corporeal membrane oxygenation)support in critically ill adult patients. Heart Lung Circ, 2008, 17(4):s41-47.
3.	孙丽娜, 王宁夫. 体外膜肺氧合的临床进展. 心血管病学进展 2013, 34(3):416-419.
4.	Douflé GF, Niall D. Monitoring during extracorporeal membrane oxygenation. Curr Opin Crit Care, 2016, 22(3):230-238.
5.	Ghislaine D, Andrew R, Filio B, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care, 2015, 19:326.
6.	李彤, 段大为, 赵成秀, 等. 体外膜式氧合的临床应用. 中国胸心心血管外科临床杂志, 2009, 16(2):149-151.
7.	袁媛, 高国栋, 龙村, 等. 107例体外膜式氧合并发症回顾分析.心肺血管病杂志, 2010, 29 (4):296-300.
8.	Li CL, Wang H, Jia M, et al. The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support:A retrospective observational study. J Thorac Cardiovasc Surg, 2015, 149(5):1445-1450.
9.	Flécher E, Anselmi A, Corbineau H, et al. Current aspects of extracorporeal membrane oxygenation in a tertiary referral centre:determinants of survival at follow-up. Eur J Cardiothorac Surg, 2014, 46(4):665-671.
10.	Li J, Long C, Lou S, et al. Venoarterial extracorporeal membrane oxygenation in adult patients:predictors of mortality. Perfusion, 2009, 24(4):225-230.
11.	杜中涛, 邢家林, 刘峰, 等. 经股动脉插管建立体外膜肺氧合严重下肢缺血危险因素分析. 中国体外循环杂志, 2013, 11(3):150-153.
12.	Quarti A, Iezzi F, Santoro G, et al. Femoral artery cannulation through a side graft in extracorporeal membrane oxygenation. Heart Lung Vessel, 2014, 6(2):125-127.
13.	张海波, 孟旭, 韩杰, 等. 危重症心脏外科患者的ECMO辅助技术与IABP、CRRT、呼吸机的相互配合治疗策略. 中国胸心心血管外科临床杂志, 2014, 30(2):71-75.
14.	Ma P, Zhang Z, Song T, et al. Combining ECMO with IABP for the treatment of critically Ill adult heart failure patients. Heart Lung Circ, 2014, 23(4):363-368.
15.	Kumar TK, Zurakowski D, Dalton H, et al. Extracorporeal membrane oxygenationin postcardiotomy patients:Factors influencing outcome. J Thorac Cardiovasc Surg, 2010, 140:330-336.
16.	Santiago MJ, Sánchez A, López-Herce J, et al. The use of continuous renal replacement therapy in series with extracorporeal membrane oxygenation. Kidney Int, 2009, 76(12):1289-1292.
17.	Paden ML, Warshaw BL, Heard ML, et al. Recovery of renal function and survival after continuous renal replacement therapy during extracorporeal membrane oxygenation. Pediatr Crit Care Med, 2011, 12(2):153-158.
18.	Federico P, Marina P, Blanca A, et al. Timing and strategy for weaning from venoarterial ECMO are complex issues. J Cardiothorac Vasc Anesthes, 2015, 29(4):906-911.
19.	罗新锦, 王巍, 孙寒松, 等. 体外膜式氧合支持治疗失败原因的初步分析. 中国胸心血管外科临床杂志, 2009, 16 (3):192-194.
20.	罗天戈, 韩杰, 王坚刚, 等. 82例成人心脏术后应用体外膜肺氧合的相关并发症分析. 中华胸心血管外科杂志, 2013, 29(3):151-155.

1. 龙村, 主编. 体外膜式氧合. 第1版. 北京:人民卫生出版社, 2010. 413-414.
2. Marasco SF, Lukas G, McDonald M, et al. Review of ECMO(extra corporeal membrane oxygenation)support in critically ill adult patients. Heart Lung Circ, 2008, 17(4):s41-47.
3. 孙丽娜, 王宁夫. 体外膜肺氧合的临床进展. 心血管病学进展 2013, 34(3):416-419.
4. Douflé GF, Niall D. Monitoring during extracorporeal membrane oxygenation. Curr Opin Crit Care, 2016, 22(3):230-238.
5. Ghislaine D, Andrew R, Filio B, et al. Echocardiography for adult patients supported with extracorporeal membrane oxygenation. Crit Care, 2015, 19:326.
6. 李彤, 段大为, 赵成秀, 等. 体外膜式氧合的临床应用. 中国胸心心血管外科临床杂志, 2009, 16(2):149-151.
7. 袁媛, 高国栋, 龙村, 等. 107例体外膜式氧合并发症回顾分析.心肺血管病杂志, 2010, 29 (4):296-300.
8. Li CL, Wang H, Jia M, et al. The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support:A retrospective observational study. J Thorac Cardiovasc Surg, 2015, 149(5):1445-1450.
9. Flécher E, Anselmi A, Corbineau H, et al. Current aspects of extracorporeal membrane oxygenation in a tertiary referral centre:determinants of survival at follow-up. Eur J Cardiothorac Surg, 2014, 46(4):665-671.
10. Li J, Long C, Lou S, et al. Venoarterial extracorporeal membrane oxygenation in adult patients:predictors of mortality. Perfusion, 2009, 24(4):225-230.
11. 杜中涛, 邢家林, 刘峰, 等. 经股动脉插管建立体外膜肺氧合严重下肢缺血危险因素分析. 中国体外循环杂志, 2013, 11(3):150-153.
12. Quarti A, Iezzi F, Santoro G, et al. Femoral artery cannulation through a side graft in extracorporeal membrane oxygenation. Heart Lung Vessel, 2014, 6(2):125-127.
13. 张海波, 孟旭, 韩杰, 等. 危重症心脏外科患者的ECMO辅助技术与IABP、CRRT、呼吸机的相互配合治疗策略. 中国胸心心血管外科临床杂志, 2014, 30(2):71-75.
14. Ma P, Zhang Z, Song T, et al. Combining ECMO with IABP for the treatment of critically Ill adult heart failure patients. Heart Lung Circ, 2014, 23(4):363-368.
15. Kumar TK, Zurakowski D, Dalton H, et al. Extracorporeal membrane oxygenationin postcardiotomy patients:Factors influencing outcome. J Thorac Cardiovasc Surg, 2010, 140:330-336.
16. Santiago MJ, Sánchez A, López-Herce J, et al. The use of continuous renal replacement therapy in series with extracorporeal membrane oxygenation. Kidney Int, 2009, 76(12):1289-1292.
17. Paden ML, Warshaw BL, Heard ML, et al. Recovery of renal function and survival after continuous renal replacement therapy during extracorporeal membrane oxygenation. Pediatr Crit Care Med, 2011, 12(2):153-158.
18. Federico P, Marina P, Blanca A, et al. Timing and strategy for weaning from venoarterial ECMO are complex issues. J Cardiothorac Vasc Anesthes, 2015, 29(4):906-911.
19. 罗新锦, 王巍, 孙寒松, 等. 体外膜式氧合支持治疗失败原因的初步分析. 中国胸心血管外科临床杂志, 2009, 16 (3):192-194.
20. 罗天戈, 韩杰, 王坚刚, 等. 82例成人心脏术后应用体外膜肺氧合的相关并发症分析. 中华胸心血管外科杂志, 2013, 29(3):151-155.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Extracorporeal Membrane Oxygenation after Cardiac Surgery: A Clinical Analysis of 27 Adult Patients

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