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Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients

BACKGROUND/AIM: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up pro...

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Autores principales: ÖZLÜER, Yunus Emre, AVCİL, Mücahit, EGE, Duygu, ŞEKER YAŞAR, Kezban
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Scientific and Technological Research Council of Turkey 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203146/
https://www.ncbi.nlm.nih.gov/pubmed/32950047
http://dx.doi.org/10.3906/sag-2004-308
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author ÖZLÜER, Yunus Emre
AVCİL, Mücahit
EGE, Duygu
ŞEKER YAŞAR, Kezban
author_facet ÖZLÜER, Yunus Emre
AVCİL, Mücahit
EGE, Duygu
ŞEKER YAŞAR, Kezban
author_sort ÖZLÜER, Yunus Emre
collection PubMed
description BACKGROUND/AIM: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures. MATERIALS AND METHODS: This retrospective and observational study included eight patients who received ECMO from January 2018 to January 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMO net scores, the management process, and patient outcomes. Blood gas analyses done after the first hour of ECMO initiation and the reevaluation of the patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores in the 24th hour of ECMO were recorded. RESULTS: The mean age was 52.7 ± 14.2 years. The median duration of the ECMO run was 81 (min–max: 4–267) h, and the mean length of CCU stay was 10.2 ± 6.7 days. Of the 8 patients studied, 5 (62.5%) had veno-arterial and 3 (37.5%) had veno-venous ECMO. Three patients were successfully weaned (37.5%). The overall survival-to-discharge rate was 25%. Carbon dioxide levels were significantly decreased 1 h after ECMO initiation (P = 0.038) as well as the need for vasopressors. Lactate levels were lower in decannulated patients. Changes in the APACHE II score were more consistent with the clinical deterioration in patients than SOFA score changes were. CONCLUSIONS: In the early phase of ECMO, vital signs improve, and the need for vasopressors and carbon dioxide levels decrease. Thus, CCUs in Emergency Departments with ECMO capabilities could potentially be designed, and emergency department ECMO algorithms could be tailored for critically ill patients in addition to out-of-hospital cardiac arrest patients.
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spelling pubmed-82031462021-06-24 Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients ÖZLÜER, Yunus Emre AVCİL, Mücahit EGE, Duygu ŞEKER YAŞAR, Kezban Turk J Med Sci Article BACKGROUND/AIM: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures. MATERIALS AND METHODS: This retrospective and observational study included eight patients who received ECMO from January 2018 to January 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMO net scores, the management process, and patient outcomes. Blood gas analyses done after the first hour of ECMO initiation and the reevaluation of the patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores in the 24th hour of ECMO were recorded. RESULTS: The mean age was 52.7 ± 14.2 years. The median duration of the ECMO run was 81 (min–max: 4–267) h, and the mean length of CCU stay was 10.2 ± 6.7 days. Of the 8 patients studied, 5 (62.5%) had veno-arterial and 3 (37.5%) had veno-venous ECMO. Three patients were successfully weaned (37.5%). The overall survival-to-discharge rate was 25%. Carbon dioxide levels were significantly decreased 1 h after ECMO initiation (P = 0.038) as well as the need for vasopressors. Lactate levels were lower in decannulated patients. Changes in the APACHE II score were more consistent with the clinical deterioration in patients than SOFA score changes were. CONCLUSIONS: In the early phase of ECMO, vital signs improve, and the need for vasopressors and carbon dioxide levels decrease. Thus, CCUs in Emergency Departments with ECMO capabilities could potentially be designed, and emergency department ECMO algorithms could be tailored for critically ill patients in addition to out-of-hospital cardiac arrest patients. The Scientific and Technological Research Council of Turkey 2021-04-30 /pmc/articles/PMC8203146/ /pubmed/32950047 http://dx.doi.org/10.3906/sag-2004-308 Text en Copyright © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Article
ÖZLÜER, Yunus Emre
AVCİL, Mücahit
EGE, Duygu
ŞEKER YAŞAR, Kezban
Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title_full Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title_fullStr Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title_full_unstemmed Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title_short Emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
title_sort emergency department extracorporeal membrane oxygenation may also include noncardiac arrest patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203146/
https://www.ncbi.nlm.nih.gov/pubmed/32950047
http://dx.doi.org/10.3906/sag-2004-308
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