PPTA | Immunoglobulin Literature Database
| Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation. |
Rescue for acute myocarditis with shock by extracorporeal membrane oxygenation. Chen YS, Wang MJ, Chou NK, Han YY, Chiu IS, Lin FY, Chu SH, Ko WJ. Department of Surgery, National Taiwan University Hospital, Taipei. BACKGROUND: Acute myocarditis (AM) complicated with refractory cardiogenic shock carries a very high mortality. We report our experience in treating these patients, who were rescued by extracorporeal membrane oxygenation (ECMO) and intravenous immunoglobulin. METHODS: Over a 5-year period, 5 patients with AM were rescued with ECMO in our hospital. Femoral venoarterial ECMO was performed in 4 patients, and right atrium-left atrium-aorta ECMO in the other 1 due to ventricular dysfunction. Hemofiltration was applied to 3 patients. Marked elevated creatine kinase, its MB form, and troponin T (TnT) were found before ECMO. RESULTS: All the patients could be weaned off the ECMO after 140.0+/-57.7 hours of ECMO support. One patient died of multiple organ failure 10 days later after removal of ECMO, resulting in a 20% mortality. Renal function returned to normal in all survivors. The 4 survivors were discharged uneventfully in 23.3+/-8.3 days and resumed functional class I status. The TnT level declined to the low level within 3 days (slope -4.94+/-1.18 ng/mL/day), and might be an indicator of good recovery of myocardium. CONCLUSIONS: ECMO can provide an effective and simple treatment for critical AM with a satisfactory result and reduce the possibility of progressive cardiomyopathy. PMID: 10617006 [PubMed - indexed for MEDLINE]
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