Extracorporeal membrane oxygenation-assisted primary percutaneous coronary intervention may improve survival of patients with acute myocardial infarction complicated by profound cardiogenic shock

被引：101

作者：

Tsao, Nai-Wen ^{[2
]}

Shih, Chun-Ming ^{[1
,3
]}

Yeh, Jong-Shiuan ^{[4
]}

Kao, Yung-Ta ^{[3
]}

Hsieh, Ming-Hsiung ^{[4
]}

Ou, Keng-Liang ^{[5
]}

Chen, Jaw-Wen ^{[6
]}

Shyu, Kou-Gi ^{[7
]}

Weng, Zen-Chung ^{[2
]}

Chang, Nen-Chung ^{[1
,3
]}

Lin, Feng-Yen ^{[1
,3
,5
]}

Huang, Chun-Yao ^{[1
,3
,5
,7
]}

机构：

[1] Taipei Med Univ, Coll Med, Sch Med, Dept Internal Med, Taipei 11031, Taiwan

[2] Taipei Med Univ Hosp, Dept Surg, Div Cardiovasc Surg, Taipei 11031, Taiwan

[3] Taipei Med Univ Hosp, Dept Internal Med, Div Cardiol, Taipei 11031, Taiwan

[4] Taipei Med Univ, Wan Fang Hosp, Div Cardiol, Taipei 11031, Taiwan

[5] Taipei Med Univ, Biomed Apparat Res Ctr, Taipei 11031, Taiwan

[6] Taipei Vet Gen Hosp, Div Cardiol, Taipei 11031, Taiwan

[7] Taipei Med Univ, Coll Med, Grad Inst Clin Med, Taipei 11031, Taiwan

来源：

JOURNAL OF CRITICAL CARE | 2012年 / 27卷 / 05期

关键词：

Acute myocardial infarction; Cardiogenic shock; Extracorporeal membrane oxygenation; Percutaneous coronary intervention; TO-BALLOON TIME; EARLY REVASCULARIZATION; CARDIOPULMONARY-RESUSCITATION; NATIONAL REGISTRY; LIFE-SUPPORT; RISK SCORE; MORTALITY; MANAGEMENT; ANGIOPLASTY; TRIAL;

D O I：

10.1016/j.jcrc.2012.02.012

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: The aim of this study was to evaluate the impact of extracorporeal membrane oxygenation (ECMO) assistance on the clinical outcome of patients with acute myocardial infarction (AMI) that is complicated by profound cardiogenic shock (CS) who received primary percutaneous coronary intervention (PCI). Materials and Methods: We collected patients from January 2004 through December 2006 (stage 1); 25 patients who presented with AMI and received primary PCI and had profound CS were enrolled in the study. Intraaortic balloon counterpulsation (IABP) was the only modality for extracorporeal support in our hospital. From January 2007 through December 2009 (stage 2), 33 patients who presented with AMI and received primary PCI and had profound CS were enrolled; for this stage; both intra-aortic balloon counter-pulsation and ECMO support were available in our facility. Results: A Kaplan-Meier survival analysis displayed significantly improved survival for patients in stage 2 (P = .001; 1-year survival in stage 1 vs 2; 24% vs 63.64%). Patients presenting with either STEMI (ST segment elevation myocardial infarction) or NSTEMI (Non-ST segment elevation myocardial infarction) benefited from ECMO-assisted PCI (P < .05). In stage 1, patients with refractory ventricular tachycardia/ventricular fibrillation had a very low survival rate; however, in stage 2, the survival rate of patients with and without refractory ventricular tachycardia/ventricular fibrillation was similar (P = .316). Conclusion: Extracorporeal membrane oxygenation-assisted PCI for patients with AMI that is complicated by profound CS may improve the 30-day and 1-year survival rates. (C) 2012 Elsevier Inc. All rights reserved.

引用

页码：530.e1 / 530.e11

页数：11

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