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Liu X, Song Y. Application of extracorporeal membrane oxygenation for acute fulminant myocarditis. Asian J Surg 2023; 46:5395-5396. [PMID: 37537059 DOI: 10.1016/j.asjsur.2023.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Xudong Liu
- Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Yanyan Song
- Department of Cardiovascular Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
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Hu L, Peng K, Huang X, Wang Z, Wu Y, Zhu H, Ma J, Chen C. A novel strategy sequentially linking mechanical cardiopulmonary resuscitation with extracorporeal cardiopulmonary resuscitation optimizes prognosis of refractory cardiac arrest: an illustrative case series. Eur J Med Res 2022; 27:77. [PMID: 35643583 PMCID: PMC9145112 DOI: 10.1186/s40001-022-00711-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Extracorporeal membrane oxygenation (ECMO) to support cardiopulmonary resuscitation (CPR), also known as extracorporeal cardiopulmonary resuscitation (ECPR), has shown encouraging results in refractory cardiac arrest (RCA) resuscitation. However, its therapeutic benefits are linked to instant and uninterrupted chest compression (CC), besides early implementation. Mechanical CC can overcome the shortcomings of conventional manual CC, including fatigue and labor consumption, and ensure adequate blood perfusion. A strategy sequentially linking mechanical CPR with ECPR may earn extra favorable outcomes. Case series We present a four-case series with ages ranging from 8 to 94 years who presented with prolonged absences of return of spontaneous circulation (ROSC) after CA associated with acute fulminant myocarditis (AFM) and myocardial infarction (MI). All the cases received VA-ECMO (ROTAFLOW, Maquet) assisted ECPR, with intra-aortic balloon pump (IABP) or continuous renal replacement treatment (CRRT) appended if persistently low mean blood pressure (MAP) or ischemic kidney injury occurred. All patients have successfully weaned off ECMO and the assistant life support devices with complete neurological recovery. Three patients were discharged, except the 94-year-old patient who died of irreversible sepsis 20 days after ECMO weaning-off. These encouraging results will hopefully lead to more consideration of this lifesaving therapy model that sequentially integrates mechanical CPR with ECPR to rescue RCA related to reversible cardiac causes. Conclusions This successful case series should lead to more consideration of an integrated lifesaving strategy sequentially linking mechanical cardiopulmonary resuscitation with ECPR, as an extra favorable prognosis of refractory cardiac arrest related to this approach can be achieved. Supplementary Information The online version contains supplementary material available at 10.1186/s40001-022-00711-1.
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Gu Y, Xue P, Chen HL, Zou G, Ni Y, Li L, Lu L, Chen H, Zheng A. Full recovery after prolonged resuscitation in a pediatric patient due to fulminant myocarditis: a case report with three-year follow-up. BMC Pediatr 2022; 22:95. [PMID: 35172767 PMCID: PMC8848653 DOI: 10.1186/s12887-022-03158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Fulminant myocarditis (FM) is a common life-threatening disease in pediatric patients, which can result in sudden cardiac arrest (CA). Whether prolonged cardiopulmonary resuscitation (CPR) is beneficial to FM induced CA is unknown. Case presentation We reported the case of an 8-year-old child with FM. At 14:49 of the day after admission, the ECG monitoring indicated ventricular flutter. The patient was immediately given continuous external cardiac compression. Electric cardioversion (energy 30J) and electric defibrillation (energy 50 J, 100 J, 100 J) were given. Continuous chest compression was conducted until extracorporeal membrane oxygenation (ECMO) successfully placed at 19:30 P.M. The total duration of CPR was 291 min. Nine days later, the ECMO was removed; and 29 days later, the patient was discharged from hospital. In the three years of follow-up, the boy showed a full recovery without neurological sequela. At present, his daily activities have returned to normal and his academic performance at school is excellent. Conclusions Prolonged CPR can be used in FM induced in-hospital CA in pediatric patients, especially during preparation for ECMO after the failure of standard resuscitation measures.
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Affiliation(s)
- Yanping Gu
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Peng Xue
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China.
| | - Hong-Lin Chen
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Guojin Zou
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Yongcheng Ni
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Lin Li
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Lijuan Lu
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Hao Chen
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
| | - Aibin Zheng
- Affiliated Changzhou Children's Hospital of Nantong University, No.468, middle Yanling Road, Tianning District, Changzhou City, Jiangsu province, People's Republic of China
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