Associations with 30-day survival following extracorporeal membrane oxygenation in patients with acute ST segment elevation myocardial infarction and profound cardiogenic shock.
BACKGROUND
Limited data are available regarding the role of percutaneous cardiopulmonary support for the treatment of ST segment elevation myocardial infarction (STEMI) with profound cardiogenic shock (CS). The aim of this study is to identify the determinant factors for survival of patients with STEMI who underwent extracorporeal membrane oxygenation (ECMO) support.


METHODS
From January 2005 to December 2013, 192 patients experienced STEMI with CS needed intra-aortic balloon pumping and support with vasoactive agents at our hospital. Among them, 51 patients experienced profound CS and needed ECMO support.


RESULTS
Higher body mass index (BMI) level, longer door-to-balloon time, higher serum blood urea nitrogen (BUN) level, and lower 24 h lactic acid clearance were associated with 30-day mortality post-ECMO.


CONCLUSIONS
Longer door-to-balloon time, higher BMI, higher serum BUN level, and poorer lactic acid clearance following ECMO placement for patients with STEMI and profound CS could predict 30-day clinical outcomes.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Wei-Chieh
WC
Lee
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Chih-Yuan
CY
Fang
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Huang-Chung
HC
Chen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Chien-Jen
CJ
Chen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Cheng-Hsu
CH
Yang
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Chi-Ling
CL
Hang
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Hon-Kan
HK
Yip
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.
Hsiu-Yu
HY
Fang
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC. Electronic address: leeweichieh1217@hotmail.com.
Chiung-Jen
CJ
Wu
D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
30-day mortality; Cardiogenic shock; Extracorporeal membrane oxygenation; Lactic acid; Myocardial infarction