K. Jacoby, Ramiro Saavedra, Matthew Spanier, Joshua S. Huelster, Alex R Campbell, Claire S. Smith, B. Dawud, C. S. St. Hill
{"title":"Veno-Arterial Extracorporeal Membrane Oxygenation in Adults with Septic Shock","authors":"K. Jacoby, Ramiro Saavedra, Matthew Spanier, Joshua S. Huelster, Alex R Campbell, Claire S. Smith, B. Dawud, C. S. St. Hill","doi":"10.18535/ijmsci/v9i01.01","DOIUrl":null,"url":null,"abstract":"Survivors and non-survivors were compared for 20 adults supported with veno-arterial extracorporeal membrane oxygenation (VA ECMO) for refractory septic shock from 2012-2018. The primary outcome was hospital survival. Secondary outcomes were ECMO associated complications and survival to decannulation. Median age was 53.5 (IQR 42.0-61.3). At ≤ 24 hours prior to cannulation, median SOFA score was 17.5 (IQR 15 - 19) and 17 patients (85%) had new cardiac dysfunction. Median left ventricular ejection fraction (LVEF) was 20% (IQR 10-38). Thirteen patients had a mixed (cardiogenic and distributive) or cardiogenic shock profile (65%), 7 had a distributive shock profile (35%), and 17 (85%) survived to decannulation. Fourteen (70%) survived to hospital discharge and median cerebral performance category score was 1 (IQR 1-2). No differences were found in age, comorbid conditions, time from shock onset to cannulation, peak flow rate on ECMO, ECMO complications, shock profile, LVEF, or vasoactive-inotrope score (VIS). More patients in the distributive shock profile experienced limb ischemia complications (n=3, 42.9%) compared to the cardiogenic and mixed shock profiles (n=1, 7.7%). Survivors to hospital discharge had a lower SOFA score. VA ECMO support may be a beneficial therapy for refractory septic shock and could be considered in select adult patients.","PeriodicalId":14151,"journal":{"name":"International Journal Of Medical Science And Clinical Invention","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal Of Medical Science And Clinical Invention","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18535/ijmsci/v9i01.01","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Survivors and non-survivors were compared for 20 adults supported with veno-arterial extracorporeal membrane oxygenation (VA ECMO) for refractory septic shock from 2012-2018. The primary outcome was hospital survival. Secondary outcomes were ECMO associated complications and survival to decannulation. Median age was 53.5 (IQR 42.0-61.3). At ≤ 24 hours prior to cannulation, median SOFA score was 17.5 (IQR 15 - 19) and 17 patients (85%) had new cardiac dysfunction. Median left ventricular ejection fraction (LVEF) was 20% (IQR 10-38). Thirteen patients had a mixed (cardiogenic and distributive) or cardiogenic shock profile (65%), 7 had a distributive shock profile (35%), and 17 (85%) survived to decannulation. Fourteen (70%) survived to hospital discharge and median cerebral performance category score was 1 (IQR 1-2). No differences were found in age, comorbid conditions, time from shock onset to cannulation, peak flow rate on ECMO, ECMO complications, shock profile, LVEF, or vasoactive-inotrope score (VIS). More patients in the distributive shock profile experienced limb ischemia complications (n=3, 42.9%) compared to the cardiogenic and mixed shock profiles (n=1, 7.7%). Survivors to hospital discharge had a lower SOFA score. VA ECMO support may be a beneficial therapy for refractory septic shock and could be considered in select adult patients.