Therapeutic Strategy for Refractory Cardiogenic Shock Patients on ECMO

Abstract

V-A ECMO（extracorporeal membrane oxygenation）has been utilized in the treatment of refractory cardiogenic shock and cardiac arrest. For those who remain dependent on ECMO, VAD（ventricular assist device）or central ECMO should be applied at the appropriate time to prevent and treat multiple organ failure.

We investigated clinical outcomes of cardiogenic shock patients treated with V-A ECMO with in the previous five years（n=69）. ECMO could be weaned off in 22（31.9%）patients, while VAD or Central ECMO was applied to 16（23.2%）patients. Thirty-one（44.9%）died on ECMO. Depending on the presence or absence of pulmonary congestion, right ventricular failure or organ dysfunction, different types of VAD/central ECMO were applied. As a result, acute phase organ dysfunction could be resolved before switching to long term mechanical circulatory support in survivors.