Header

UZH-Logo

Maintenance Infos

Survival, quality of life and impact of right heart failure in patients with acute cardiogenic shock treated with ECMO


Schoenrath, Felix; Hoch, Dennis; Maisano, Francesco; Starck, Christoph T; Seifert, Burkhardt; Wenger, Urs; Ruschitzka, Frank; Wilhelm, Markus J (2016). Survival, quality of life and impact of right heart failure in patients with acute cardiogenic shock treated with ECMO. Heart & Lung: The Journal of Acute and Critical Care, 45(5):409-415.

Abstract

BACKGROUND Mechanical circulatory support is increasingly used in acute cardiogenic shock. OBJECTIVE To assess treatment strategies for cardiogenic shock. METHODS Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed. RESULTS: Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6.3%. Elevated lactate and hemorrhagic complications (all p in patients with right heart failure prior to ECMO implantation, BVAD therapy showed a trend (p=0.058) towards superior survival compared with LVAD therapy. Seven of the BVAD patients received successful transplantation, with a 1-year survival of 71%. Among survivors Short Form 36 reported significantly lower combined physical scores (p=0.004). CONCLUSIONS Right heart assessment prior to ECMO implantation may be beneficial to provide tailored therapy if ECMO weaning fails. Survival after cardiogenic shock requiring ECMO seems to be associated with impaired long-term quality of life.

Abstract

BACKGROUND Mechanical circulatory support is increasingly used in acute cardiogenic shock. OBJECTIVE To assess treatment strategies for cardiogenic shock. METHODS Data of 57 patients in acute intrinsic cardiogenic shock treated with ECMO were analyzed. Different subsequent strategies (weaning, VAD, transplantation) were followed. RESULTS: Overall 1, 2, and 4-year survival was 36.8 ± 6.4%, 32.2 ± 6.4%, 29.8 ± 6.3%. Elevated lactate and hemorrhagic complications (all p in patients with right heart failure prior to ECMO implantation, BVAD therapy showed a trend (p=0.058) towards superior survival compared with LVAD therapy. Seven of the BVAD patients received successful transplantation, with a 1-year survival of 71%. Among survivors Short Form 36 reported significantly lower combined physical scores (p=0.004). CONCLUSIONS Right heart assessment prior to ECMO implantation may be beneficial to provide tailored therapy if ECMO weaning fails. Survival after cardiogenic shock requiring ECMO seems to be associated with impaired long-term quality of life.

Statistics

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:8 August 2016
Deposited On:07 Sep 2016 12:24
Last Modified:07 Feb 2017 12:28
Publisher:Elsevier
ISSN:0147-9563
Publisher DOI:https://doi.org/10.1016/j.hrtlng.2016.07.005
PubMed ID:27515989

Download

Full text not available from this repository.
View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations