Extracorporeal membrane oxygenation to rescue heart failure in acute fulminant myocarditis.docVIP

 PAGE \* MERGEFORMAT 9 Extracorporeal membrane oxygenation to rescue heart failure in acute fulminant myocarditis Author: Yao Hao, LIU Chang, LI Qing-guo, Zhou Qing, Zhang Jie, Li Xin, Wang Dongjin [Keywords:] extracorporeal membrane oxygenation; acute fulminant myocarditis; heart failure 1 Data and methods 1.1 The clinical data of patients with female, 31 years old, weight 50 kg. Due to diagnosis of ‘acute fulminant myocarditis (acute fulminant myocarditis, AFM) cardiogenic shock’ on November 2, 2008 live in heart closed medical intensive care unit, giving oxygen, high-dose step-up drug, methylprednisolone, vitamin C, Hu Xin Tong, as well as ribavirin and other treatment, and into the deep venous catheter, install temporary cardiac pacemakers and intra-aortic balloon counterpulsation (intra-aortic balloon pump, IABP) assist device. It difficult to maintain due to circulation after admission had numerous rescue, liver and kidney function continued to deteriorate. Seventh day of hospitalization in patients with sustained ventricular tachycardia, dopamine, dobutamine, norepinephrine pump output continued to increase blood pressure remained low, only to be maintained at 45 ~ 50 mmHg/20 ~ 26 mmHg. Agitated patients, and gradually consciousness, self-breathing shallow and irregular, double-pupil dilated, light reflex disappeared, gradually emergency line of external chest compression and endotracheal intubation mechanical ventilation breathing machine. Considered in patients with severe myocardial damage, cardiac pump function in severe failure, cardiogenic shock is difficult Correction, liver and kidney failure, decided to immediately OK bedside ECMO (extracorporeal membrane oxygenation, ECMO) support treatment. 1.2 ECMO management of the establishment and use of ECMO installations MAQUET-JOSTRA full heparin-coated pipes, QUANDOX-D membrane oxygenator and centrifugal pump systems. Selected VA ECMO model, intravenous injection of 100 u / kg of heparin, the skin