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Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience

Background and Objectives: Extracorporeal membrane oxygenation (ECMO) can be helpful in patients with cardiogenic shock associated with myocardial infarction, and its early use can improve the patient survival rate. In this study, we report a mortality rate-difference analysis that examined the time...

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Autores principales: Shin, Dong-Geum, Shin, Sang-Deock, Han, Donghoon, Kang, Min-Kyung, Lee, Seung-Hun, Kim, Jihoon, Cho, Jung-Rae, Kim, Kunil, Choi, Seonghoon, Lee, Namho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465743/
https://www.ncbi.nlm.nih.gov/pubmed/34577809
http://dx.doi.org/10.3390/medicina57090886
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author Shin, Dong-Geum
Shin, Sang-Deock
Han, Donghoon
Kang, Min-Kyung
Lee, Seung-Hun
Kim, Jihoon
Cho, Jung-Rae
Kim, Kunil
Choi, Seonghoon
Lee, Namho
author_facet Shin, Dong-Geum
Shin, Sang-Deock
Han, Donghoon
Kang, Min-Kyung
Lee, Seung-Hun
Kim, Jihoon
Cho, Jung-Rae
Kim, Kunil
Choi, Seonghoon
Lee, Namho
author_sort Shin, Dong-Geum
collection PubMed
description Background and Objectives: Extracorporeal membrane oxygenation (ECMO) can be helpful in patients with cardiogenic shock associated with myocardial infarction, and its early use can improve the patient survival rate. In this study, we report a mortality rate-difference analysis that examined the time and location of shock occurrence. Materials and Methods: We enrolled patients who underwent ECMO due to cardiogenic shock related to myocardial infarction and assigned them to either a pre- or post-admission shock group. The primary outcome was the 1-month mortality rate; a subgroup analysis was conducted to assess the effect of bailout ECMO. Results: Of the 113 patients enrolled, 67 (38 with pre-admission shock, 29 with post-admission shock) were analysed. Asystole was more frequently detected in the pre-admission shock group than in the post-admission group. In both groups, the commonest culprit lesion location was in the left anterior descending artery. Cardiopulmonary resuscitation was performed significantly more frequently and earlier in the pre-admission group. The 1-month mortality rate was significantly lower in the pre-admission group than in the post-admission group. Male sex and ECMO duration (≥6 days) were factors significantly related to the reduced mortality rate in the pre-admission group. In the subgroup analysis, the mortality rate was lower in patients receiving bailout ECMO than in those not receiving it; the difference was not statistically significant. Conclusions: ECMO application resulted in lower short-term mortality rate among patients with out-of-hospital cardiogenic shock onset than with in-hospital shock onset; early cardiopulmonary resuscitation and ECMO might be helpful in select patients.
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spelling pubmed-84657432021-09-27 Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience Shin, Dong-Geum Shin, Sang-Deock Han, Donghoon Kang, Min-Kyung Lee, Seung-Hun Kim, Jihoon Cho, Jung-Rae Kim, Kunil Choi, Seonghoon Lee, Namho Medicina (Kaunas) Article Background and Objectives: Extracorporeal membrane oxygenation (ECMO) can be helpful in patients with cardiogenic shock associated with myocardial infarction, and its early use can improve the patient survival rate. In this study, we report a mortality rate-difference analysis that examined the time and location of shock occurrence. Materials and Methods: We enrolled patients who underwent ECMO due to cardiogenic shock related to myocardial infarction and assigned them to either a pre- or post-admission shock group. The primary outcome was the 1-month mortality rate; a subgroup analysis was conducted to assess the effect of bailout ECMO. Results: Of the 113 patients enrolled, 67 (38 with pre-admission shock, 29 with post-admission shock) were analysed. Asystole was more frequently detected in the pre-admission shock group than in the post-admission group. In both groups, the commonest culprit lesion location was in the left anterior descending artery. Cardiopulmonary resuscitation was performed significantly more frequently and earlier in the pre-admission group. The 1-month mortality rate was significantly lower in the pre-admission group than in the post-admission group. Male sex and ECMO duration (≥6 days) were factors significantly related to the reduced mortality rate in the pre-admission group. In the subgroup analysis, the mortality rate was lower in patients receiving bailout ECMO than in those not receiving it; the difference was not statistically significant. Conclusions: ECMO application resulted in lower short-term mortality rate among patients with out-of-hospital cardiogenic shock onset than with in-hospital shock onset; early cardiopulmonary resuscitation and ECMO might be helpful in select patients. MDPI 2021-08-27 /pmc/articles/PMC8465743/ /pubmed/34577809 http://dx.doi.org/10.3390/medicina57090886 Text en © 2021 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 Article
Shin, Dong-Geum
Shin, Sang-Deock
Han, Donghoon
Kang, Min-Kyung
Lee, Seung-Hun
Kim, Jihoon
Cho, Jung-Rae
Kim, Kunil
Choi, Seonghoon
Lee, Namho
Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title_full Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title_fullStr Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title_full_unstemmed Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title_short Features of Patients Receiving Extracorporeal Membrane Oxygenation Relative to Cardiogenic Shock Onset: A Single-Centre Experience
title_sort features of patients receiving extracorporeal membrane oxygenation relative to cardiogenic shock onset: a single-centre experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8465743/
https://www.ncbi.nlm.nih.gov/pubmed/34577809
http://dx.doi.org/10.3390/medicina57090886
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