Extracorporeal life support for adults with refractory septic shock

The Journal of Thoracic and Cardiovascular Surgery
Sun Kyun RoJoon Bum Kim

Abstract

Although the use of extracorporeal membrane oxygenation (ECMO) in shock patients is increasing worldwide, studies concerning this treatment for adult septic shock are limited. This study aimed to analyze the outcome of venoarterial ECMO in adult patients with septic shock refractory to conventional treatment. A total of 71 consecutive patients who presented with septic shock and underwent venoarterial ECMO were reviewed. Clinical parameters were compared between survivors and nonsurvivors. Weaning and survival outcomes of these patients were compared with the control group of 253 patients who received venoarterial ECMO for cardiogenic shock. The mean age was 56.0 ± 12.3 years. Of the 71 septic shock patients, 11 (15.5%) were successfully weaned from ECMO after a median of 7.9 [interquartile range (IQR), 6.3-10.2] days, 5 of whom (7.0%) survived to discharge. Pre- and 6 hours post-procedural lactate levels were significantly higher in the nonsurvivors (11.6 [IQR, 7.5-15.0] vs 5.8 [IQR, 4.3-5.9], P = .036; 15.0 [IQR, 11.1-15.0] vs 5.2 [IQR, 4.7-5.4], P = .002). Rates of successful weaning from venoarterial ECMO (15.5% vs 45.5%), and of survival up to hospital discharge (7.0% vs 28.9%) were significantly lower in septic shock than...Continue Reading

Citations

May 23, 2019·Current Opinion in Critical Care·Marc Pineton de ChambrunAlain Combes
Mar 19, 2020·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Alexander BuiaErnst Hanisch
Sep 5, 2020·The European Respiratory Journal·Trevor J Williams, Vincent Pellegrino
Aug 1, 2019·Medizinische Klinik, Intensivmedizin und Notfallmedizin·L BalkeB Bewig
Sep 16, 2020·Artificial Organs·Zaki HaidariAlexander Weymann
Jul 13, 2021·Circulation. Heart Failure·Darshan H BrahmbhattFilio Billia

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