体外膜肺氧合在暴发型心肌炎致心脏骤停中的应用

doi:10.3969/j.issn.1002-1949.2017.10.007

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (10): 903-906 DOI: 10.3969/j.issn.1002-1949.2017.10.007

Application of the extracorporeal membrane oxygenation in cardiac arrest caused by fulminant myocarditis

Chen Xu-feng, Mei Yong, Lv Jin-ru, Hu De-liang, Zhang Gang, Zhang Jin-song

Emergency Department Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

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Abstract Objective: To investigate the value of emergency extracorporeal membrane oxygenation(ECMO)in cardiopulmonary resuscitation(CPR)induced by fulminant myocarditis(FM), and to provide a new advanced life support method for FM. Methods: From June 2015 to December 2016 in our hospital, seven cases of cardiac arrest patients caused by fulminant myocarditis were implemented with ECMO. Three of them were men; four was female, age: 15 ～ 58 years, average age(29.3±11.5)years. They were treated by venous arterial(V-A)mode, CPR time: 50 ～ 180 min average(78±45.8)min; CPR to start the ECMO time: 8 ～15 min, average(11.6±2.63)min; established the ECMO time: 40 ～ 65 min, average(52.1±9.49)min; maintained ECMO time: 121～288 h, average(162.1±71.3)h. Results: Six patients recovered spontaneous rhythm; they were successfully weaned from ECMO and survived(85.7%). One case died of infection and complication of central nerve system; in the ECMO period, CRRT in five cases, artery intubation oozing of blood in one case, limb ischemic necrosis in one case. Conclusion: The application of ECMO in the treatment of FM, especially early application, has a good effect. Therefore, it is recommended for adults with FM first-line support treatment.

Received: 06 June 2017

Corresponding Authors: Zhang Jin-song, E-mail: zhangjso@163.com

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	Chen Xu-feng
	Mei Yong
	Lv Jin-ru
	Hu De-liang
	Zhang Gang
	Zhang Jin-song

Cite this article:

Chen Xu-feng,Mei Yong,Lv Jin-ru, et al. Application of the extracorporeal membrane oxygenation in cardiac arrest caused by fulminant myocarditis[J]. Chinese Journal of Critical Care Medicine, 2017, 37(10): 903-906.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.10.007 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I10/903

［1］Hazinski MF, John M， Field,et al. 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science［J］. Circulation, 2010, 122:S639-934.  ［2］Kennedy JH. The role of assisted circulation in cardiac resuscitation［J］. JAMA, 1966, 197(8):615-618. ［3］Ginsberg F, Parrillo JE. Fulminant myocarditis［J］. Crit Care Clin, 2013, 29(3):465-483. ［4］Cox AT, White S, Ayalew Y, et al. Myocarditis and the military patient［J］. J R Army Med Corps, 2015, 161(3):275-282. ［5］Chen YS, Lin JW, Yu HY, et al. Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in hospital cardiac arrest: an observational study and propensity analysis［J］. Lancet, 2008, 372(9638):554 -561. ［6］Atluri P, Ullery BW, MacArthur JW, et al. Rapid onset of fulminant myocarditis portends a favourable prognosis and the ability to bridge mechanical circulatory support to recovery［J］. Eur J Cardiothorac Surg, 2013, 43(2):379-382. ［7］Lorusso R, Centofanti P, Gelsomino S, et al. Venoarterial Extracorporeal Membrane Oxygenation for Acute Fulminant Myocarditis in Adult Patients: A 5-Year Multi-Institutional Experience［J］. Ann Thorac Surg, 2016, 101(3):919-926. ［8］Baslaim G, Bashore J, Al-Malki F, et al . Can the outcome of pediatric extracorporeal membrane oxygenation after cardiac surgery be predicted［J］. Ann Thorac Cardiovasc Surg, 2006, 12(1):21-27. ［9］Paden ML, Conrad SA, Rycus PT, et al. Extracorporeal life support organization registry report 2012［J］. ASAIO J, 2013, 59(3):202-210. ［10］Haneya A, Philipp A, Diez C, et al. A 5-year experience with cardiopulmonary resuscitation using extracorporeal life support in non-postcardiotomy patients with cardiac arrest［J］. Resuscitation, 2012, 83(11):1331–1337. ［11］Masson R, Colas V, Parienti JJ, et al. A comparison of survival with and without extracorporeal life support treatment for severe poisoning due to drug intoxication［J］. Resuscitation, 2012, 83(11):1413-1417. ［12］Parhar K, Vuylsteke A. What′s new in ECMO: scoring the bad indications［J］. Intensive Care Med, 2014, 40(11):1734-1737. ［13］龙村. 体外膜肺氧合循环支持专家共识［J］. 中国体外循环杂志， 2014, 12(2):65-67. ［14］Nakamura T, Ishida K, Taniguchi Y, et al. Prognosis of patients with fulminant myocarditis managed by peripheral venoarterial extracorporeal membranous oxygenation support: a retrospective single-center study［J］. J Intensive Care, 2015, 3(1):5. ［15］Cheng R, Hachamovitch R, Kittleson M, et al. Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients［J］. Ann Thorac Surg, 2014, 97(2):610-616.