Author/Authors :
Oh, You Na Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Oh, Dong Kyu Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Koh, Younsuck Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Lim, Chae-Man Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Huh, Jin-Won Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Lee, Jae Seung Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Jung, Sung-Ho Departments of Thoracic and Cardiovascular Surgery - Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Kang, Pil-Je Departments of Thoracic and Cardiovascular Surgery - Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea , Hong, Sang-Bum Departments of Asan Medical Center - University of Ulsan College of Medicine - Seoul, Korea
Abstract :
Background: Although extracorporeal membrane oxygenation (ECMO) has been used for the
treatment of acute high-risk pulmonary embolism (PE), there are limited reports which focus
on this approach. Herein, we described our experience with ECMO in patients with acute
high-risk PE.
Methods: We retrospectively reviewed medical records of patients diagnosed with acute highrisk PE and treated with ECMO between January 2014 and December 2018.
Results: Among 16 patients included, median age was 51 years (interquartile range [IQR], 38
to 71 years) and six (37.5%) were male. Cardiac arrest was occurred in 12 (75.0%) including
two cases of out-of-hospital arrest. All patients underwent veno-arterial ECMO and median
ECMO duration was 1.5 days (IQR, 0.0 to 4.5 days). Systemic thrombolysis and surgical embolectomy were performed in seven (43.8%) and nine (56.3%) patients, respectively including
three patients (18.8%) received both treatments. Overall 30-day mortality rate was 43.8%
(95% confidence interval, 23.1% to 66.8%) and 30-day mortality rates according to the treatment groups were ECMO alone (33.3%, n=3), ECMO with thrombolysis (50.0%, n=4) and
ECMO with embolectomy (44.4%, n=9).
Conclusions: Despite the vigorous treatment efforts, patients with acute high-risk PE were
related to substantial morbidity and mortality. We report our experience of ECMO as rescue
therapy for refractory shock or cardiac arrest in patients with PE.
Keywords :
embolectomy , extracorporeal membrane oxygenation , pulmonary embolism , shock , thrombolytic therapy , treatment outcome
