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Associations with 30-day survival following extracorporeal membrane oxygenation in patients with acute ST segment elevation myocardial infarction and profound cardiogenic shock

Heart Lung. 2016 Nov-Dec;45(6):532-537. doi: 10.1016/j.hrtlng.2016.08.006. Epub 2016 Sep 3.

Abstract

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.

Method: 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.

Keywords: 30-day mortality; Cardiogenic shock; Extracorporeal membrane oxygenation; Lactic acid; Myocardial infarction.

MeSH terms

  • Extracorporeal Membrane Oxygenation*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • ST Elevation Myocardial Infarction / complications
  • ST Elevation Myocardial Infarction / mortality
  • ST Elevation Myocardial Infarction / therapy*
  • Shock, Cardiogenic / etiology*
  • Shock, Cardiogenic / mortality
  • Shock, Cardiogenic / therapy
  • Survival Rate / trends
  • Taiwan / epidemiology
  • Time Factors