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Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report

ECMO has become a therapeutic modality for in- and out-of-hospital scenarios and is also suitable as a bridging therapy until further decisions and interventions can be made. Case report: A 27-year-old male patient with mechanical aortic valve prothesis had a sudden cardiac arrest (SCA). ROSC had be...

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Autores principales: Kiss, Boldizsár, Nagy, Bettina, Pál-Jakab, Ádám, Lakatos, Bálint, Soltész, Ádám, Osztheimer, István, Heltai, Krisztina, Édes, István Ferenc, Németh, Endre, Merkely, Béla, Zima, Endre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342643/
https://www.ncbi.nlm.nih.gov/pubmed/37445284
http://dx.doi.org/10.3390/jcm12134249
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author Kiss, Boldizsár
Nagy, Bettina
Pál-Jakab, Ádám
Lakatos, Bálint
Soltész, Ádám
Osztheimer, István
Heltai, Krisztina
Édes, István Ferenc
Németh, Endre
Merkely, Béla
Zima, Endre
author_facet Kiss, Boldizsár
Nagy, Bettina
Pál-Jakab, Ádám
Lakatos, Bálint
Soltész, Ádám
Osztheimer, István
Heltai, Krisztina
Édes, István Ferenc
Németh, Endre
Merkely, Béla
Zima, Endre
author_sort Kiss, Boldizsár
collection PubMed
description ECMO has become a therapeutic modality for in- and out-of-hospital scenarios and is also suitable as a bridging therapy until further decisions and interventions can be made. Case report: A 27-year-old male patient with mechanical aortic valve prothesis had a sudden cardiac arrest (SCA). ROSC had been achieved after more than 60 min of CPR and eight DC shocks due to ventricular fibrillation (VF). The National Ambulance Service unit transported the patient to our clinic for further treatment. Due to the trauma and therapeutic INR, a CT scan was performed and ruled out bleeding. Echocardiography described severely decreased left ventricular function. Coronary angiography was negative. Due to the therapeutic refractory circulatory and respiratory failure against intensive care, VA-ECMO implantation was indicated. After four days of ECMO treatment, the patient’s circulation was stabilized without neurological deficit, and the functions of the end organs were normalized. Cardiac MRI showed no exact etiology behind SCA. ICD was implanted due to VF and SCA. The patient was discharged after 19 days of hospitalization. Conclusion: This case report points out that the early application of mechanical circulatory support could be an outcome-determinant therapeutic modality. Post-resuscitation care includes cardiorespiratory stabilization, treatment of reversible causes of malignant arrhythmia, and secondary prevention.
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spelling pubmed-103426432023-07-14 Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report Kiss, Boldizsár Nagy, Bettina Pál-Jakab, Ádám Lakatos, Bálint Soltész, Ádám Osztheimer, István Heltai, Krisztina Édes, István Ferenc Németh, Endre Merkely, Béla Zima, Endre J Clin Med Case Report ECMO has become a therapeutic modality for in- and out-of-hospital scenarios and is also suitable as a bridging therapy until further decisions and interventions can be made. Case report: A 27-year-old male patient with mechanical aortic valve prothesis had a sudden cardiac arrest (SCA). ROSC had been achieved after more than 60 min of CPR and eight DC shocks due to ventricular fibrillation (VF). The National Ambulance Service unit transported the patient to our clinic for further treatment. Due to the trauma and therapeutic INR, a CT scan was performed and ruled out bleeding. Echocardiography described severely decreased left ventricular function. Coronary angiography was negative. Due to the therapeutic refractory circulatory and respiratory failure against intensive care, VA-ECMO implantation was indicated. After four days of ECMO treatment, the patient’s circulation was stabilized without neurological deficit, and the functions of the end organs were normalized. Cardiac MRI showed no exact etiology behind SCA. ICD was implanted due to VF and SCA. The patient was discharged after 19 days of hospitalization. Conclusion: This case report points out that the early application of mechanical circulatory support could be an outcome-determinant therapeutic modality. Post-resuscitation care includes cardiorespiratory stabilization, treatment of reversible causes of malignant arrhythmia, and secondary prevention. MDPI 2023-06-25 /pmc/articles/PMC10342643/ /pubmed/37445284 http://dx.doi.org/10.3390/jcm12134249 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Kiss, Boldizsár
Nagy, Bettina
Pál-Jakab, Ádám
Lakatos, Bálint
Soltész, Ádám
Osztheimer, István
Heltai, Krisztina
Édes, István Ferenc
Németh, Endre
Merkely, Béla
Zima, Endre
Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title_full Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title_fullStr Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title_full_unstemmed Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title_short Early Application of ECMO after Sudden Cardiac Arrest to Prevent Further Deterioration: A Review and Case Report
title_sort early application of ecmo after sudden cardiac arrest to prevent further deterioration: a review and case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10342643/
https://www.ncbi.nlm.nih.gov/pubmed/37445284
http://dx.doi.org/10.3390/jcm12134249
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