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Emergency department extracorporeal membrane oxygenation may also include non-cardiac arrest patients.

PMID: 32950047 (view PubMed database entry)
DOI: 10.3906/sag-2004-308 (read at publisher's website )

Yunus Emre ÖzlÜer, MÜcahİt Avcİl, Duygu Ege, Kezban Şeker YaŞar,

BACKGROUND/AIM:The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit of an Emergency Department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures. MATERIALS AND METHODS:This retrospective, observational study included eight patients who received Extracorporeal Membrane Oxygenation from Jan 2018?Jan 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMOnet scores, the management process, and patient outcomes. Blood gas analyses from after the first hour of ECMO initiation and the re-evaluation of the patients? Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the 24th hour of ECMO were recorded. RESULTS:The mean age was 52.7 ± 14.2 years. The mean duration of the ECMO run was 112.8±108.2 hours, and the mean length of CCU stay was 10.2 ± 6.7 days. Of the 8 patients studied, 5 had veno-arterial (62.5%) and 3 had veno-venous ECMO (37.5%). Three patients were successfully weaned (37.5%). The overall survival-to-discharge rate was 25%. Carbon dioxide levels were significantly decreased 1 hour after ECMO initiation (p=0.038) as well as the need for vasopressors. Lactate levels were lower in decannulated patients. Changes in the APACHE II score were more consistent with the clinical deterioration in patients than were SOFA score changes. CONCLUSIONS:In the early phase of ECMO, vital signs improve, and the need for vasopressors and carbon dioxide levels decreases. Thus, Critical Care Units in Emergency Departments with ECMO capabilities could potentially be designed, and emergency department ECMO algorithms could be tailored for critically ill in addition to out-of-hospital cardiac arrest patients.

Turk J Med Sci (Turkish journal of medical sciences)
[2020, :]

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