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[Extracorporeal membrane oxygenation in the peri-operative period of heart transplantation].
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Nov; 37(11):1014-7.ZX

Abstract

OBJECTIVE

To summarize and analyze clinical outcomes and experience about using extracorporeal membrane oxygenation (ECMO) in supporting heart transplant patients in the peri-operative period of in Fuwai Hospital retrospectively.

METHODS

We performed 131 orthotopic heart transplantations from June 2004 to December 2008. Fourteen cases used veno-artery ECMO (Medtronic Ltd) for mechanical circulatory support in the peri-operative period of heart transplantation. Active clotting time(ACT) was maintained between 160 - 200 seconds, mean blood flow was 1.8 - 3.3 L/min during ECMO assistant period.

RESULTS

Twelve survivals discharged with NYHAI, two patients died of multiple orgen failure with severe infection and complication of central nervous system. The ECMO time was 75 - 824 h and mean time 149 h. 12 survivals with ECMO assistance decreases the dose of vasoactive drugs, after bedside UCG evaluating heart function recovery with stable circulation, ECMO could be weaned off uneventfully after 100 h. Five patients with seven times bleeding complication and one patient with catheter-associated arterial thrombosis of distal limb, all ECMO patients with low-albuminemia and hyperbilirubinemia at some degree, eleven patients with increasing blood creatine and five patients were treated with continous renal replacement therapy, one patient with pertinacious hyperbilirubinemia was treated with plasma exchange and molecular absorbent recirculating system. Seven patients were extension incision healing and six patients were tracheotomy.

CONCLUSIONS

ECMO can bridge patients with end-stage heart failure to heart transplant, and extend the use of marginal donors, grasp the ECMO indication and timing of application, avoiding irreversible dysfunction of the vital organs and preventing complication during ECMO, ECMO may decrease mortality of severe patients in the peri-operative period of heart transplantation.

Authors+Show Affiliations

Wang W
Department of Cardiac Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy Science and Peking Union Medical College, Beijing 100037, China.
Liao ZK
No affiliation info available
Hu SS
No affiliation info available
Song YH
No affiliation info available
Huang J
No affiliation info available

MeSH

Extracorporeal Membrane OxygenationHeart FailureHeart TransplantationHospital MortalityHumansPerioperative CareRetrospective StudiesTreatment Outcome

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

20137329

Citation

Wang, Wei, et al. "[Extracorporeal Membrane Oxygenation in the Peri-operative Period of Heart Transplantation]." Zhonghua Xin Xue Guan Bing Za Zhi, vol. 37, no. 11, 2009, pp. 1014-7.
Wang W, Liao ZK, Hu SS, et al. [Extracorporeal membrane oxygenation in the peri-operative period of heart transplantation]. Zhonghua Xin Xue Guan Bing Za Zhi. 2009;37(11):1014-7.
Wang, W., Liao, Z. K., Hu, S. S., Song, Y. H., & Huang, J. (2009). [Extracorporeal membrane oxygenation in the peri-operative period of heart transplantation]. Zhonghua Xin Xue Guan Bing Za Zhi, 37(11), 1014-7.
Wang W, et al. [Extracorporeal Membrane Oxygenation in the Peri-operative Period of Heart Transplantation]. Zhonghua Xin Xue Guan Bing Za Zhi. 2009;37(11):1014-7. PubMed PMID: 20137329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Extracorporeal membrane oxygenation in the peri-operative period of heart transplantation]. AU - Wang,Wei, AU - Liao,Zhong-Kai, AU - Hu,Sheng-Shou, AU - Song,Yun-Hu, AU - Huang,Jie, PY - 2010/2/9/entrez PY - 2010/2/9/pubmed PY - 2010/5/19/medline SP - 1014 EP - 7 JF - Zhonghua xin xue guan bing za zhi JO - Zhonghua Xin Xue Guan Bing Za Zhi VL - 37 IS - 11 N2 - OBJECTIVE: To summarize and analyze clinical outcomes and experience about using extracorporeal membrane oxygenation (ECMO) in supporting heart transplant patients in the peri-operative period of in Fuwai Hospital retrospectively. METHODS: We performed 131 orthotopic heart transplantations from June 2004 to December 2008. Fourteen cases used veno-artery ECMO (Medtronic Ltd) for mechanical circulatory support in the peri-operative period of heart transplantation. Active clotting time(ACT) was maintained between 160 - 200 seconds, mean blood flow was 1.8 - 3.3 L/min during ECMO assistant period. RESULTS: Twelve survivals discharged with NYHAI, two patients died of multiple orgen failure with severe infection and complication of central nervous system. The ECMO time was 75 - 824 h and mean time 149 h. 12 survivals with ECMO assistance decreases the dose of vasoactive drugs, after bedside UCG evaluating heart function recovery with stable circulation, ECMO could be weaned off uneventfully after 100 h. Five patients with seven times bleeding complication and one patient with catheter-associated arterial thrombosis of distal limb, all ECMO patients with low-albuminemia and hyperbilirubinemia at some degree, eleven patients with increasing blood creatine and five patients were treated with continous renal replacement therapy, one patient with pertinacious hyperbilirubinemia was treated with plasma exchange and molecular absorbent recirculating system. Seven patients were extension incision healing and six patients were tracheotomy. CONCLUSIONS: ECMO can bridge patients with end-stage heart failure to heart transplant, and extend the use of marginal donors, grasp the ECMO indication and timing of application, avoiding irreversible dysfunction of the vital organs and preventing complication during ECMO, ECMO may decrease mortality of severe patients in the peri-operative period of heart transplantation. SN - 0253-3758 UR - https://www.unboundmedicine.com/medline/citation/20137329/[Extracorporeal_membrane_oxygenation_in_the_peri_operative_period_of_heart_transplantation]_ DB - PRIME DP - Unbound Medicine ER -