体外膜肺氧合
医学
叶轮
心源性休克
缺氧(环境)
心脏病学
内科学
充氧
麻醉
心肌梗塞
化学
有机化学
氧气
作者
Kodai Shibao,Tatsuhiro Shibata,Chisato Kitamura,Yoshihisa Matushima,Takumi Yoshiga,Toshiyuki Yanai,Takehiro Homma,Maki Otsuka,Kenta Murotani,Yoshihiro Fukumoto
出处
期刊:Asaio Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2024-05-16
被引量:1
标识
DOI:10.1097/mat.0000000000002229
摘要
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a therapeutic strategy for managing cardiogenic shock. However, it carries the risk of cardiogenic pulmonary edema, potentially leading to differential hypoxia. Although IMPELLA can mitigate pulmonary congestion, the combination of VA-ECMO and IMPELLA has frequently resulted in differential hypoxia, requiring a transition from VA-ECMO to veno-arteriovenous extracorporeal membrane oxygenation (VAV-ECMO). Therefore, this study aimed to examine the influence of IMPELLA on the incidence of differential hypoxia, necessitating a shift to VAV-ECMO. This single-center, retrospective, observational study included patients who experienced cardiopulmonary arrest and received treatment with VA-ECMO combined with an intra-aortic balloon pump (IABP) or IMPELLA between 2017 and 2022. The primary endpoint assessed the incidence of differential hypoxia, necessitating a switch to VAV-ECMO. Patients with cardiopulmonary arrest received treatment with VA-ECMO in combination with IABP (N = 28) or IMPELLA (N = 29). There was a significant increase in differential hypoxia 96 hours post-VA-ECMO initiation in the IMPELLA group, necessitating a transition to VAV-ECMO. The combination of VA-ECMO and IMPELLA in patients experiencing cardiopulmonary arrest may significantly increase the risk of differential hypoxia. A multidisciplinary approach employing mechanical circulatory support is crucial, with ongoing consideration of the potential risks associated with differential hypoxia.
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