Clinical determinants of successful weaning from extracorporeal membrane oxygenation in patients with fulminant myocarditis

ESC Heart Failure
Manabu MatsumotoSatoshi Yasuda

Abstract

Patients with fulminant myocarditis (FM) often present with cardiogenic shock and require mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist device (VAD) implantation. This study sought to clarify the determinants of successful weaning from ECMO in FM patients. We studied 37 consecutive FM patients supported by ECMO as the initial form of mechanical circulatory support between January 1995 and December 2014 in our hospital. Twenty-two (59%) patients were successfully weaned from ECMO, while 15 (41%) were not. There were significant differences in levels of peak creatine kinase and those of its MB isoform (CK-MB), left ventricular posterior wall thickness (LVPWT), and prevalence of cardiac rhythm disturbances. Receiver operating characteristic curve analysis revealed that a peak CK-MB level of 185 IU/L and LVPWT of 11 mm were the optimal cut-off values for predicting successful weaning from ECMO (areas under the curve, 0.89 and 0.85, respectively). During the follow-up [median 48 (interquartile range 8-147) months], 83% of FM patients who were weaned from ECMO survived, with preserved fractional shortening based on echocardiography. Of the 15 FM patients who were not weane...Continue Reading

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Citations

Sep 5, 2020·The European Respiratory Journal·Trevor J Williams, Vincent Pellegrino
Feb 23, 2020·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Satsuki FukushimaTomoyuki Fujita
Jun 27, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Naoki TadokoroTomoyuki Fujita
Mar 18, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Shingo OhkiNobuaki Shime
Jul 13, 2021·Circulation. Heart Failure·Darshan H BrahmbhattFilio Billia
Sep 4, 2021·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·John M TrahanasDavid A D'Alessandro
Feb 6, 2020·Recent Patents on Inflammation & Allergy Drug Discovery·Ronald C M FungAlexander K C Leung
Nov 23, 2021·The Journal of International Medical Research·Heyu MengPing Yang

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