0172 : Refractory electrical storm rescued by venoarterial extracorporeal membrane oxygenation

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• 作者：Guillaume Baudry<sup> ; sup><sup>baudryguillaume@gmail.com" class="auth_mail" title="E-mail the corresponding authorsup> ; Guillaume Lebreton ; Guillaume Hekimian ; Nicolas Br&eacute ; chot ; Ania Nieszkowska ; Charles-Edouard Luyt ; Jean-Louis Trouillet ; Pascal Leprince ; Alain Combes
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：8
• 期：3
• 页码：230-231
• 全文大小：61 K

文摘

Electrical storm refers to a state of cardiac electrical instability characterized by multiple episodes of ventricular tachycardia or ventricular fibrillation within 24 hours despite antiarrhythmic drugs or devicerelated therapies and for which overall mortality was 22-82% in previous series. Since Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can be used as a rescue therapy in this setting, we reviewed our experience and assessed the outcomes of patients who received VA-ECMO for refractory electrical storm in our center.

absSec_2">Method

spar0010">We retrospectively collected demographic, pre and post ECMO data and in-ICU mortality of patients who received VA-ECMO for refractory electrical storm in our intensive care unit from March 2007 to March 2015.

absSec_3">Results

spar0015">38 patients had ECMO for refractory electrical storm. Median age, SAPS II and SOFA scores at admission were 58 (49-62) years, 80 (55-87) and 13 (11-15), respectively. Electrical storm was secondary to myocardial infarction in 26 (68%) patients. Cannulation was performed during and after cardiac arrest in 5 (13%) and 17 (45%) patients, respectively. Overall ICU survival was 47%. Survivors spent 5 (4-10) days on ECMO, 14 (9-25) days in ICU and 52 (34-59) days in hospital. Patients discharged alive from the ICU had lower body mass index, lower SOFA score before ECMO and at day 1 and received less inotropes in the 24h following cannulation (p=0.02). No difference was identified between alive and deceased patients regarding pre-ECMO antiarrhythmic treatments and number of electrical shocks.

absSec_4">Conclusion

spar0020">Refractory electrical storm is a very severe condition that might be rescued by VA-ECMO support. The 47% ICU survival rate we observed in this series parallels that of other cardiogenic shock populations rescued by VA-ECMO. Earlier ECMO support in the course of the disease might allow a rapid decrease in inotrope doses and less organ failures, which were both associated with more favorable outcomes.

spar1005">The author hereby declares no conflict of interest