Extracorporeal life support in patients with refractory cardiogenic shock: keep them awake

Interactive Cardiovascular and Thoracic Surgery
Prashant N MohiteAndre Ruediger Simon

Abstract

Traditionally, patients on extracorporeal life support (ECLS) are sedated and mechanically ventilated and therefore prone to complications related to immobility and ventilation. We adopted this 'Awake ECLS' strategy for the patients with refractory cardiogenic shock (RCS) as a bridge to decision. Sixty-eight patients with RCS were supported by ECLS (All veno-arterial) in years 2010-2014. Patients that could not survive 24 h after ECLS implantation (9 patients) were excluded from the study. Study population constituted 59 patients-'Awake' group (n = 18; maintained awake without intubation) and 'Control' group (n = 41; intubated and required mechanical ventilation). Nine (50%) patients were awake at implantation, with 5 of them remaining free of sedation and ventilator support through to explantation. Nine patients were ventilated at the time of implantation but subsequently extubated and remained non-intubated and ventilator free. Post-ECLS survival at 1 month was 78 and 42% while the survival to discharge was 78 and 37% in awake and control group, respectively. ECLS as a bridge to decision in RCS is effective in restoring adequate systemic perfusion and recovering end-organ function. ECLS can be initiated in awake patients with...Continue Reading

References

Jan 1, 1994·Chest·F KonradM Georgieff
Feb 5, 2008·The Journal of Thoracic and Cardiovascular Surgery·Farhad BakhtiaryAnton Moritz
Jul 20, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K M OlssonM M Hoeper
Oct 12, 2010·The Journal of Thoracic and Cardiovascular Surgery·Claudio F RussoLuigi Martinelli
Jan 24, 2012·American Journal of Respiratory and Critical Care Medicine·Thomas FuehnerGregor Warnecke
Dec 30, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Ashleigh XiePaul Forrest

❮ Previous
Next ❯

Citations

Apr 5, 2017·Interactive Cardiovascular and Thoracic Surgery·Friedhelm Beyersdorf
Apr 7, 2021·European Heart Journal. Acute Cardiovascular Care·Santiago MonteroMatthieu Schmidt

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.