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Abstract

Introduction:

The role of extracorporeal support for patients with septic shock remains unclear.

Methods:

We conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database.

Results:

Twelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3.0 to 5.3) between 01/2014 and 12/2017. Five patients (41.7%) had a cardiac arrest prior to initiation of ECMO support. At baseline, median left ventricular ejection fraction was 16.25% (IQR 13.13 to 17.5) and median PaO₂/FiO₂ ratio was 9 kPa (IQR 6.5 to 12.0) [67.50 mmHg (IQR 48.75 to 90.00)]. The survival rate to hospital discharge for VAV ECMO was 75% in this cohort. None of the surviving patients died within the follow-up period (median six month).

Conclusion:

VAV ECMO is a feasible rescue strategy for a small proportion of patients with combined respiratory and cardiac failure secondary to septic shock with septic cardiomyopathy. We provide a detailed report of our experience with this technique. Further research is required comparing the different extracorporeal strategies directly to conventional resuscitation and against each other.

Keywords

Extracorporeal life support Extracorporeal membrane oxygenation (ECMO)Veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO)Septic cardiomyopathy Septic shock Severe respiratory failure Acute heart failure

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Veno-arterio-venous ECMO for septic cardiomyopathy: a single-centre experience

Abstract

Introduction:

Methods:

Results:

Conclusion:

Keywords

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References