摘要
Abstract
Objective To explore the clinical efficacy of extracorporeal membrane oxygenation (ECMO) in the treatment of refractory cardiogenic shock and to analyze factors affecting the clinical efficacy.Methods We retrospectively analyzed the clinical data of 9 patients with refractory cardiogenic shock treated by ECMO from January 2016 to June 2016,ECMO pre-status,ECMO timing,ECMO complications and curative effects,The dose of vasoactive drugs and hemodynamic changes were collected before and during 2 h,6 h,12 h,24 h and 48 h of ECMO use.Results 5 males and 4 females were selected in our study,aged from 12 to 56 years old,with acute myocardial infarction in 3 cases,acute fulminant myocarditis in 4 cases,paroxysmal ventricular tachycardia in 1 case,coronary artery bypass grafting in 1 case.6 patients underwent CPR with CPR time ranged from10 to 180 mins.2 patients underwent PCI.1 patient with acute extensive anterior myocardial infarction experienced a three-degree atrioventricular block after resuscitation and implanted pacemaker;1 case of temporary pacemaker with ventricular tachycardia;2 patients with IABP support.The mean arterial pressure increased at 2 h after application of ECMO,the central venous pressure decreased,the central venous oxygen saturation increased,the amount of vasoactive drugs decreased gradually,and the differences were statistically significant (P<0.05).After 12 hours of ECMO support,the lactic acid level began to decline with pH value improved,and the differences were statistically significant (P<0.05).Shock was improved with stable hemodynamics after 24 hours of ECMO.ECMO auxiliary time ranged from 12 to 220 h.8 of 9 cases were successfully weaned(88.9％),with 5 of whom survived to discharge(55.6％).4 patients died due to acute renal insufficiency,disseminated intravascular coagulation,delayed application of ECMO,a variety of complications,abandon of treatment by family and other causes.Conclusion ECMO can quickly improve cardiogenic shock in patients and maintain the stability of hemodynamics.Timely ECMO use,improvement of clinical care and reduction of body complications are the key to improve the efficacy of ECMO.关键词
体外膜肺氧合/心源性休克/效果/影响因素Key words
Extracorporeal membrane oxygenation/Cardiogenic shock/Effect/Influence factor
