scholarly journals Modified Extracorporeal Membrane Oxygenation Offers Stable Hemodynamic Conditions with Less Invasiveness in Coronary Artery Bypass Grafting

2020 ◽  
Vol 26 (2) ◽  
pp. 29-39
Author(s):  
Koji Hirano ◽  
Toshiya Tokui ◽  
Bun Nakamura ◽  
Ryosai Inoue ◽  
Reina Hirano ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Predictors for unsuccessful weaning from venoarterial extracorporeal membrane oxygenation in patients undergoing coronary artery bypass grafting

Perfusion ◽  
2020 ◽  
Vol 35 (7) ◽  
pp. 598-607
Author(s):  
Juanjuan Shao ◽  
Liangshan Wang ◽  
Hong Wang ◽  
Xiaotong Hou
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Confidence Interval ◽  
Extracorporeal Membrane Oxygenation ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation

Background: Studies reporting risk factors associated with unsuccessful weaning for coronary artery bypass grafting patients on venoarterial extracorporeal membrane oxygenation are scarce. This study was designed to identify factors associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Methods: Data from 166 coronary artery bypass grafting patients supported with venoarterial extracorporeal membrane oxygenation at the Beijing Anzhen Hospital between February 2004 and March 2017 were retrospectively analyzed. Multivariable logistic regression was performed using bootstrapping methodology to identify factors independently associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Results: A total of 106 patients (64%) could be weaned from venoarterial extracorporeal membrane oxygenation, and 74 patients (45%) were alive at hospital discharge. The 30-day and 60-day survival rates after ECMO weaning were 72% and 70%, respectively. Pre-existing hypertension (odds ratio, 2.54; 95% confidence interval, 1.16-5.56; p = 0.02), serum creatinine (+1 μmol/L; odds ratio, 1.008; 95% confidence interval, 1.003-1.013; p = 0.001), and serum lactate (+1 mmol/L; odds ratio, 1.17; 95% confidence interval, 1.08-1.26; p = 0.001) were independent risk factors associated with unsuccessful weaning from venoarterial extracorporeal membrane oxygenation. Higher platelet count was protective (+1 × 109/L; odds ratio, 0.992; 95% confidence interval, 0.986-0.998; p = 0.011). The area under the receiver operating characteristic curve 0.81 (95% confidence interval, 0.75-0.88) for the logistic regression model was better than those for the survival after VA-ECMO score (p = 0.002), EuroSCORE (p < 0.001), and the prEdictioN of Cardiogenic shock OUtcome foR Acute myocardial infarction patients salvaGed by VA-ECMO scores (p = 0.02) in this population. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (0.76; 95% confidence interval, 0.68-0.83; p = 0.29) and sepsis-related organ failure assessment score (0.77; 95% confidence interval, 0.70-0.85; p = 0.46) exhibited good performances similar to the logistic regression model. Conclusion: Pre-existing hypertension, serum creatinine, serum lactate, and low platelet count were independent predictors for unsuccessful weaning from venoarterial extracorporeal membrane oxygenation in patients undergoing coronary artery bypass grafting.

scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock patients supported by ECMO underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients successfully weaned off from ECMO after their surgeries. Postoperative ECOM time ranged from 6.8 to 228 hours, with a median of 68.4 hours. Two patients died postoperatively while another six survived. The follow up time for the six patients was ranged from three to 66 months whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among the majority of the patients.

scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock, who were supported by ECMO, underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients were successfully weaned off from ECMO after their surgeries. Postoperative ECMO time ranged from 6.8 to 228.0 hours, with a median of 68.4 hours. Two patients died postoperatively while another six survived. The follow up time for the six patients ranged from three to 66 months, whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among most of the patients.

scholarly journals Surgical outcomes in cardiogenic shock patients with preoperative extracorporeal membrane oxygenation (ECMO)

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mahmoud Yousef Ibrahim Abuharb ◽  
Dong Ran ◽  
Zheng Jubing ◽  
Liu Taoshuai ◽  
Dong Haiming ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Coronary Artery Bypass ◽  
Surgical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Membrane Oxygenation

Abstract Objectives To summarise the surgical outcomes in patients with cardiogenic shock supported by preoperative extracorporeal membrane oxygenation (ECMO). Methods Between May 2012 and August 2017, eight patients with cardiogenic shock, who were supported by ECMO, underwent emergency surgery; four of them had isolated coronary artery bypass grafting, three had coronary artery bypass grafting with mitral replacement, and one had mitral valve replacement with left ventricular posterior wall repair. Results All eight patients were successfully weaned off from ECMO after their surgeries. Postoperative ECMO time ranged from 6.8 to 228.0 h, with a median of 68.4 h. Two patients died postoperatively while another six survived. The follow up time for the six patients ranged from three to 66 months, whereby one of them died in the third month due to septicaemia. The remaining five patients survived with good cardiac function based on the NYHA classification. Conclusion ECMO is a vital bridge in the preparation of critically-ill patients for cardiac surgery. It is associated with acceptable outcomes among most of the patients.

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