title: Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation.
abstract: We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified heart failure therapy was closely monitored with a pulmonary artery catheter and allowed gradual weaning off the ECMO support without additional invasive measures, notably without mechanical ventilation. Neurological assessment was possible at all times and complete physical mobilisation was straightforward directly after weaning from ECMO. This limited invasive approach may encourage a more widespread use of percutaneous VA-ECMO.
authors.affiliation: Department of Intensive Care Medicine, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3584 CX, Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van Houte
authors.forename: D W
authors.initials: DW
authors.lastname: Donker
authors.forename: L J
authors.initials: LJ
authors.lastname: Wagenaar
authors.forename: A P
authors.initials: AP
authors.lastname: Slootweg
authors.forename: J H
authors.initials: JH
authors.lastname: Kirkels
authors.forename: D
authors.initials: D
authors.lastname: van Dijk