초록접수 현황
| 20F-203 | 구연 발표 |
Experience of multidisciplinary ECMO team for acute coronary syndrome: paradigm shift of surgeon's role
In-Seok Jeong1, Do-Wan Kim1, Kyo-Seon Lee1, Min-Chul Kim2, Yong Hun Jung3
1. Department of thoracic and cardiovascular surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
2. Department of cardiology, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
3. Department of emergency medicine, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
Purpose : The importance of the multidisciplinary extracorporeal membrane oxygenation (ECMO) team approach and an integrated patient management system is well known. We evaluated the 5 year experience of multidisciplinary ECMO team for acute coronary syndrome (ACS).
Methods : Multidisciplinary ECMO team, consisting of surgeon, cardiologist, emergency department (ED) physician and perfusionist, was maintained from early 2015 in our center, but actual integrated system was initiated from October 2019. We retrospectively analyzed the clinical data of 143 ECMO patients with ACS from January 2015 to August 2020, and compared outcomes between two periods before and after the integrated system was established.
Results : Key components of integrated system are as followings: ED physician based ECMO (ED ECMO), active application of left heart unloading in the catherization room by cardiologist, sharing of ECMO resource in individual department and Integrated patient management by ECMO specialist. Overall mortality was 52.4%, and ED ECMO was performed in 53 patients (33.1%) after January 2015. But there was no statistical difference between ED ECMO and Non-ED ECMO (p value=0,084). Survival discharge was improved after integrated system establishment (before versus after system establishment, 38.4% versus 61.4%; p = 0.007).
Conclusion : The integrated system reduced in-hospital mortality of ACS patients with ECMO support. We believe that surgeon needs to change the role as integrated director in the multidisciplinary ECMO team.
Methods : Multidisciplinary ECMO team, consisting of surgeon, cardiologist, emergency department (ED) physician and perfusionist, was maintained from early 2015 in our center, but actual integrated system was initiated from October 2019. We retrospectively analyzed the clinical data of 143 ECMO patients with ACS from January 2015 to August 2020, and compared outcomes between two periods before and after the integrated system was established.
Results : Key components of integrated system are as followings: ED physician based ECMO (ED ECMO), active application of left heart unloading in the catherization room by cardiologist, sharing of ECMO resource in individual department and Integrated patient management by ECMO specialist. Overall mortality was 52.4%, and ED ECMO was performed in 53 patients (33.1%) after January 2015. But there was no statistical difference between ED ECMO and Non-ED ECMO (p value=0,084). Survival discharge was improved after integrated system establishment (before versus after system establishment, 38.4% versus 61.4%; p = 0.007).
Conclusion : The integrated system reduced in-hospital mortality of ACS patients with ECMO support. We believe that surgeon needs to change the role as integrated director in the multidisciplinary ECMO team.
책임저자: In-Seok Jeong
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital and Medical School, Gwangju, Republic of Korea
발표자: In-Seok Jeong, E-mail : isjeong1201@gmail.com