초록접수 현황
| 20F-121 | 구연 발표 |
Extracorporeal Membrane Oxygenation After Cardiac Surgery: Early versus Late Initiation
Young Su Kim, Yang Hyun Cho,
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is a standard treatment modality for refractory cardiogenic shock or cardiac arrest after cardiac surgery. However, it is very difficult to know the appropriate ECMO insertion timing.
Methods : From January 2012 to June 2019, we retrospectively reviewed patients who had VA ECMO after cardiac surgery. The exclusion criteria were age < 18 years, transportation from another hospital under ECMO, and accidental ECMO insertion. We divided the patients into two groups according to the timing of ECMO insertion: intraoperatively (intraop group) and postoperatively (postop group). The primary outcome was survival at discharge.
Results : Forty-eight patients (intraop group; n = 22, postop group; n = 26) were enrolled in the study. In the intraop group, the patients were younger (58.3 ± 11.2 vs. 65.5 ± 11.4 years; p = 0.03) and the preoperative Euroscore was lower(8.1 ± 3.1 vs. 10.2 ± 4.4; p = 0.04). The operative time and cardiopulmonary bypass time were significantly longer in the intraop group than in the postop group (p = 0.004, p = 0.01). There was more frequent extracorporeal cardiopulmonary resuscitation in the postop group than in the intraop group (38.5% vs. 9.1%; p = 0.02). The weaning success rate and survival to discharge were significantly higher in the intraop group than in the postop group (95.5% vs. 65.4%; p = 0.01; 77.3% vs. 46.2%; p = 0.04).
Conclusion : Cardiac surgery outcomes were better for intraoperative VA ECMO implement than for postoperative rescue ECMO implement. Early mechanical circulatory support may improve survival.
Methods : From January 2012 to June 2019, we retrospectively reviewed patients who had VA ECMO after cardiac surgery. The exclusion criteria were age < 18 years, transportation from another hospital under ECMO, and accidental ECMO insertion. We divided the patients into two groups according to the timing of ECMO insertion: intraoperatively (intraop group) and postoperatively (postop group). The primary outcome was survival at discharge.
Results : Forty-eight patients (intraop group; n = 22, postop group; n = 26) were enrolled in the study. In the intraop group, the patients were younger (58.3 ± 11.2 vs. 65.5 ± 11.4 years; p = 0.03) and the preoperative Euroscore was lower(8.1 ± 3.1 vs. 10.2 ± 4.4; p = 0.04). The operative time and cardiopulmonary bypass time were significantly longer in the intraop group than in the postop group (p = 0.004, p = 0.01). There was more frequent extracorporeal cardiopulmonary resuscitation in the postop group than in the intraop group (38.5% vs. 9.1%; p = 0.02). The weaning success rate and survival to discharge were significantly higher in the intraop group than in the postop group (95.5% vs. 65.4%; p = 0.01; 77.3% vs. 46.2%; p = 0.04).
Conclusion : Cardiac surgery outcomes were better for intraoperative VA ECMO implement than for postoperative rescue ECMO implement. Early mechanical circulatory support may improve survival.
책임저자: Yang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Young Su Kim, E-mail : ys9709@gmail.com