[Retrospective analysis of 100 patients managed by extracorporeal membrane oxygenation].
OBJECTIVE
To describe the experience with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support of 100 patients.


METHODS
Retrospective analysis of the medical files of 100 patients submitted to the implant of extracorporeal membrane oxygenation system for cardiorespiratory assistance of acute and refractory cardiogenic shock from December 2004 to September 2008. There were 67 males and 33 females, age ranged from 5 d to 76 years with a mean of (28+/-26) years, body mass ranged from 3.8 to 100.0 kg with a mean of (42+/-30) kg. The inter-surface of the ECMO equipment system was completely coated by heparin-coating technique. All patients were applied veno-artery ECMO and activated clotting time was maintained between 120 and 180 s and heparin usage dose was 5 to 20 Uxkg(-1)xh(-1). Mean blood flow was 40 to 220 mlxkg(-1)min(-1) during ECMO assistant period.


RESULTS
The shortest ECMO time was 12 to 504 h with a mean of (119+/-80) h. Sixty-one patients (61.0%) weaned off successfully from ECMO, 55 of them (90.2%) were discharged and 6 died of post-operative complications. Thirty-nine patients could not weaned off from ECMO. Total survival discharge rate was 55.0%. Mean aortic pressure before ECMO in survived patients was significantly higher than that of dead patients (P=0.038). Lactic acid concentration of artery blood before ECMO in survived patients was significantly lower than that of dead patients (P=0.005).


CONCLUSIONS
ECMO is an effective mechanical assistant therapy method for cardiac and pulmonary failure after cardiac surgery. Earlier usage of ECMO for heart lung failure patient and avoiding the main organs from un-recovery trauma are key success.
Yuan
Yuan
Y
Department of Extra-Corporeal Circulation, Fuwai Hospital, Chinese Academy of Medical Science, Beijing 100037, China.
Gao
Guo-dong
GD
Long
Cun
C
Hei
Fei-long
FL
Li
Jing-wen
JW
Yu
Kun
K
Liu
Jin-ping
JP
Feng
Zheng-yi
ZY
Zhao
Ju
J
Hu
Sheng-shou
SS
Xu
Jian-ping
JP
Chang
Qian
Q
Liu
Ying-long
YL
Wang
Xu
X
Liu
Ping
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D055815:Young Adult