Extracorporeal membrane oxygenation for acutefulminant myocarditis

Liu Chang-zhi; Zuo Liu-er; Chen De-zhu; Zhu Rui-qiu; Lu Jian-hai; Liu Hai-feng; Jiang Qian-hua; Hu Yun-zhao

doi:10.13498/j.cnki.chin.j.ecc.2015.03.10

Abstract：Objective To observe the clinical effect of extracorporeal membrane oxygenation ( ECMO) for patients with acute fulminant myocarditis. Methods Patients with acute fulminant myocarditis received ECMO treatment in intensive care unit of the First People's Hospital of Shunde from May 2013 to November 2014 were retrospectively analyzed. Results Refractory cardiogenic shock occurred in 4 patients. Malignant arrhythmia were complicated in 3 patients, cardiac arrest in 2 patients and medical therapy had no effect. After ECMO support for 78 to 183 hours, hemodynamics improved, myocardial damage markers( Creatine Kinase-MB, Cardiac Troponin I) decreased, cardiac systolic function improved and brain natriuretic peptide decreased. Plasma leakage on oxygenator oc?curred in 2 patients, hemorrhage at the catheterization site occurred in 2 patients, femoral arterial thrombosis occurred in 2 patients, thrombosis in great saphenous vein occurred in 1 patient. Four patients weaned ECMO support and survived to hospital discharge. They recovered well to daily lives, studies and work without chronic heart failure, cardiac dilatation ormalignant arrhythmia during the follow-up period of 7 months out to 18 months. Conclusions ECMO is an effective approach which reduces acute phase mortality, improves long-term prognosis in patients with acute fulminant myocarditis and should be used early. CTnIhas thepotential value inthe evaluation ofweaning of ECMO.