Kmiec, Lukasz and Philipp, Alois and Floerchinger, Bernhard and Lubnow, Matthias and Unterbuchner, Christoph and Creutzenberg, Markus and Lunz, Dirk and Mueller, Thomas and Schmid, Christof and Camboni, Daniele (2020) Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism as Bridge to Therapy. ASAIO JOURNAL, 66 (2). pp. 146-152. ISSN 1058-2916, 1538-943X
Full text not available from this repository. (Request a copy)Abstract
Pulmonary Embolism (PE) is a common illness in western countries. The purpose of this study is to report the institutional experience with massive PE and Extracorporeal Membrane Oxygenation (ECMO) in inoperable patients on admission. A retrospective analysis using the institutional ECMO-registry including the time between 2006 and 2017 was performed. During the study period, 75 patients (n = 46 patients venoarterial [VA], n = 29 patients venovenous [VV]) were placed on ECMO for massive PE. The primary support for massive PE consists of VA; however, VV support can be applied as well in selected cases as this work demonstrates. In the VA group, more patients (38 vs. 83%, P = 0.001) required mechanical resuscitation whereas in the VV group a more aggressive ventilation before support was noted (e.g. minute ventilation: VA=8.8 +/- 3.7 L/min, VV=11.5 +/- 4.5 L/min, P = 0.01). Survival to discharge was similar in VV and VA patients (45 vs. 48%, P = 0.9). Patients who received additional therapeutic interventions after stabilization with ECMO - e.g. surgical thrombectomy - displayed a similar survival compared with those being only anticoagulated (44% vs. 49%, P = 0.40). ECMO is feasible for initial stabilization serving as a bridge to therapy in primarily inoperable patients with massive PE. The principal configuration of support is VA; however, VV can be applied as well in selected hemodynamically compromised cases under aggressive ventilation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VENOUS THROMBOEMBOLISM; SURGICAL EMBOLECTOMY; MANAGEMENT; THROMBOLYSIS; MORBIDITY; SURVIVAL; Extracorporeal Membrane Oxygenation (ECMO); Pulmonary Embolism; Outcome |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Mar 2021 10:23 |
| Last Modified: | 30 Mar 2021 10:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45164 |
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