Institutional Experience With Venoarterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism : A Retrospective Case Series
Copyright © 2021 Elsevier Inc. All rights reserved..
OBJECTIVE: Despite advances in treatment, massive pulmonary embolism (PE) remains associated with significant morbidity and mortality. The role of venoarterial extracorporeal membrane oxygenation (VA ECMO) in the setting of massive PE is evolving and includes potential roles both in initial management and as a rescue strategy.
DESIGN: Single-center case series that reported demographics and outcomes for patients with massive PE who underwent VA ECMO.
SETTING: This investigation was performed at a quaternary referral center with several hospitals throughout the greater Atlanta, GA, area.
PARTICIPANTS: The study comprised adult patients (age ≥18 y) admitted to the authors' hospital system. Patients were identified using an internal registry of ECMO patients that contains basic demographic information (age, weight, treatment dates and times, ECMO configuration) and primary diagnosis.
INTERVENTIONS: No interventions were performed.
MEASUREMENTS AND MAIN RESULTS: Seventeen patients who met the inclusion criteria were identified, with 16 patients cannulated peripherally and one patient cannulated centrally for VA ECMO. Survival to hospital discharge was 80% for patients who underwent VA ECMO as an initial approach versus 42% for those in whom it was used as a rescue modality.
CONCLUSIONS: The results suggested that patients placed on VA ECMO earlier during their course of massive PE may have improved mortality. Additional investigation is needed to clarify the optimal sequence and timing of therapies surrounding the initiation of VA ECMO in patients with massive PE.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Journal of cardiothoracic and vascular anesthesia - 35(2021), 9 vom: 30. Sept., Seite 2681-2685 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hockstein, Maxwell A [VerfasserIn] |
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| Links: |
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| Themen: |
Circulation, extracorporeal |
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| Anmerkungen: |
Date Completed 25.10.2021 Date Revised 25.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1053/j.jvca.2020.12.045 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320920860 |
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| 100 | 1 | |a Hockstein, Maxwell A |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Institutional Experience With Venoarterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism |b A Retrospective Case Series |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 25.10.2021 | ||
| 500 | |a Date Revised 25.10.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Despite advances in treatment, massive pulmonary embolism (PE) remains associated with significant morbidity and mortality. The role of venoarterial extracorporeal membrane oxygenation (VA ECMO) in the setting of massive PE is evolving and includes potential roles both in initial management and as a rescue strategy | ||
| 520 | |a DESIGN: Single-center case series that reported demographics and outcomes for patients with massive PE who underwent VA ECMO | ||
| 520 | |a SETTING: This investigation was performed at a quaternary referral center with several hospitals throughout the greater Atlanta, GA, area | ||
| 520 | |a PARTICIPANTS: The study comprised adult patients (age ≥18 y) admitted to the authors' hospital system. Patients were identified using an internal registry of ECMO patients that contains basic demographic information (age, weight, treatment dates and times, ECMO configuration) and primary diagnosis | ||
| 520 | |a INTERVENTIONS: No interventions were performed | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Seventeen patients who met the inclusion criteria were identified, with 16 patients cannulated peripherally and one patient cannulated centrally for VA ECMO. Survival to hospital discharge was 80% for patients who underwent VA ECMO as an initial approach versus 42% for those in whom it was used as a rescue modality | ||
| 520 | |a CONCLUSIONS: The results suggested that patients placed on VA ECMO earlier during their course of massive PE may have improved mortality. Additional investigation is needed to clarify the optimal sequence and timing of therapies surrounding the initiation of VA ECMO in patients with massive PE | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a circulation, extracorporeal | |
| 650 | 4 | |a extracorporeal membrane oxygenation | |
| 650 | 4 | |a membrane oxygenation, extracorporeal | |
| 700 | 1 | |a Creel-Bulos, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Appelstein, Joshua |e verfasserin |4 aut | |
| 700 | 1 | |a Jabaley, Craig S |e verfasserin |4 aut | |
| 700 | 1 | |a Stentz, Michael J |e verfasserin |4 aut | |
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