title: [Clinical application of extracorporeal membrane oxygenation for treatment of adult refractory cardiogenic shock].
abstract: OBJECTIVE
  To summarize the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment for adult refractory cardiogenic shock.
  
  
  METHODS
  From January 2003 to January 2011, patients with refractory cardiogenic shock required veno-arterial ECMO by failure of conventional therapy and intra-aortic balloon pump counterpulsation therapy were retrospectively studied. Patients with severe traumatic brain injury, advanced malignancies and multiple organ failure were excluded. Patients were divided into weaned group (n = 31) and not weaned group (n = 23) according to the ECMO weaning.
  
  
  RESULTS
  The duration of ECMO was 24.16 (14.12, 56.75) hours. Twenty-two out of 31 patients in the weaned group survived and were discharged, 9 patients died after successfully weaned from ECMO (5 due to multisystem organ failure, 2 due to reoccurred cardiogenic shock, 1 due to infectious shock and 1 due to disseminated or diffuse intravascular coagulation). Pre-ECMO mean arterial pressure, ejection fraction, the duration of ECMO were significantly higher while pre-ECMO blood lactate [(8.64 ± 3.17) vs. (14.44 ± 2.52) , P < 0.01], the duration of ROSC [ (16.70 ± 5.29) vs. (35.64 ± 5.89), P < 0.01] and multisystem organ failure [0 vs. 17.4% (4/23) , P < 0.05] were lower in weaned group than in not wean group.
  
  
  CONCLUSIONS
  ECMO is an effective mechanical assistant therapy strategy for adult refractory cardiogenic shock patients. Timely applying this strategy on suitable patients is crucial for the success of ECMO. Cardiac function and reversibility of heart failure are key factors determine the fate of weaned or not weaned ECMO in adult refractory cardiogenic shock patients.
authors.affiliation: Emergency Department, Zhongshan Affiliated Hospital of Sun Yat-sen University, Zhongshan 528403, China.
authors.forename: Liu-sheng
authors.initials: LS
authors.lastname: Hou
authors.forename: Gang
authors.initials: G
authors.lastname: Xie
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Li
authors.forename: Chong-hui
authors.initials: CH
authors.lastname: Jiang
authors.forename: Yong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Bin-fei
authors.initials: BF
authors.lastname: Li
authors.forename: Hai-ming
authors.initials: HM
authors.lastname: Jiang
authors.forename: Ye
authors.initials: Y
authors.lastname: Ning
authors.forename: Gui-shen
authors.initials: GS
authors.lastname: Wu
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Zheng
authors.forename: Shuang-biao
authors.initials: SB
authors.lastname: Zhao
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000628:therapy*