Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2014.55.600
Results of extracorporeal life support implementation in routine clinical practice: single center experience
Bojan Biočina
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Mate Petričević
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Dražen Belina
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Hrvoje Gašparović
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Lucija Svetina
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Sanja Konosić
; Department of Anesthesiology, University Hospital Center Zagreb, Zagreb, Croatia
Alexandra White
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Višnja Ivančan
; Department of Anesthesiology, University Hospital Center Zagreb, Zagreb, Croatia
Tomislav Kopjar
; Department of Cardiac Surgery, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
Davor Miličić
; Department of Cardiovascular Diseases, University of ZagrebSchool of Medicine, UniversityHospital Center Zagreb, Zagreb,Croatia
Sažetak
Aim To describe our experience in the clinical application
of extracorporeal life support (ECLS) and analyze whether
ECLS leads to acceptable clinical outcomes in patients with
cardiac failure.
Methods Data from clinical database of University Hospital
Center Zagreb, Croatia, on 75 patients undergoing ECLS
support from 2009 to 2014 due to cardiac failure were retrospectively
analyzed. Outcomes were defined as procedural
and clinical outcomes. ECLS as a primary procedure
and ECLS as a postcardiotomy procedure due to inability
to wean from cardiopulmonary bypass were analyzed.
Results ECLS was used in 75 adult patients, and in 24
(32%) of those procedural success was noted. ECLS was
implemented as a primary procedure in 36 patients and
as a postcardiotomy procedure in 39 patients. Nine out of
39 (23.08%) patients had postcardiotomy ECLS after heart
transplantation. Bleeding complications occurred in 30
(40%) patients, both in primary (11/36 patients) and postcardiotomy
group (19/39 patients). ECLS was established
by peripheral approach in 46 patients and by central cannulation
in 27 patients. In 2 patients, combined cannulation
was performed, with an inflow cannula placed into
the right atrium and an outflow cannula placed into the
femoral artery. Eleven patients treated with peripheral approach
had ischemic complications.
Conclusion ECLS is a useful tool in the treatment of patients
with refractory cardiac failure and its results are encouraging
in patients who otherwise have an unfavorable
prognosis. Patient outcomes may be further improved by
technological advances, more clinical experience in application
of the technique, careful patient selection, and multidisciplinary
approach in patient management
Ključne riječi
Hrčak ID:
139288
URI
Datum izdavanja:
15.12.2014.
Posjeta: 1.007 *