title: Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation.
abstract: BACKGROUND
  Acute myocarditis (AM) complicated with refractory cardiogenic shock carries a very high mortality. We report our experience in treating these patients, who were rescued by extracorporeal membrane oxygenation (ECMO) and intravenous immunoglobulin.
  
  
  METHODS
  Over a 5-year period, 5 patients with AM were rescued with ECMO in our hospital. Femoral venoarterial ECMO was performed in 4 patients, and right atrium-left atrium-aorta ECMO in the other 1 due to ventricular dysfunction. Hemofiltration was applied to 3 patients. Marked elevated creatine kinase, its MB form, and troponin T (TnT) were found before ECMO.
  
  
  RESULTS
  All the patients could be weaned off the ECMO after 140.0+/-57.7 hours of ECMO support. One patient died of multiple organ failure 10 days later after removal of ECMO, resulting in a 20% mortality. Renal function returned to normal in all survivors. The 4 survivors were discharged uneventfully in 23.3+/-8.3 days and resumed functional class I status. The TnT level declined to the low level within 3 days (slope -4.94+/-1.18 ng/mL/day), and might be an indicator of good recovery of myocardium.
  
  
  CONCLUSIONS
  ECMO can provide an effective and simple treatment for critical AM with a satisfactory result and reduce the possibility of progressive cardiomyopathy.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei.
authors.forename: Y S
authors.initials: YS
authors.lastname: Chen
authors.forename: M J
authors.initials: MJ
authors.lastname: Wang
authors.forename: N K
authors.initials: NK
authors.lastname: Chou
authors.forename: Y Y
authors.initials: YY
authors.lastname: Han
authors.forename: I S
authors.initials: IS
authors.lastname: Chiu
authors.forename: F Y
authors.initials: FY
authors.lastname: Lin
authors.forename: S H
authors.initials: SH
authors.lastname: Chu
authors.forename: W J
authors.initials: WJ
authors.lastname: Ko
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D003402:Creatine Kinase / Q000097:blood; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007527:Isoenzymes; D008297:Male; D009205:Myocarditis / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000209:etiology*; D015996:Survival Rate; D020107:Troponin T / Q000097:blood
chemical_list: D016756:Immunoglobulins, Intravenous; D007527:Isoenzymes; D020107:Troponin T; D003402:Creatine Kinase