Awake VA-ECMO in cardiogenic shock, single centre experiences

Abstract

Abstract Funding Acknowledgements None. Background/Introduction "Awake" V-A ECMO when the patient is fully awake, breathing spontaneously, without deep sedation. Advantages of awake VA-ECMO include reduced sedative side effects, early active movements, reduced muscle mass loss, increased interaction with the family and medical staff, description of their symptoms, and more exact information than sedative patients so that early detection of complications. Purpose and Methods Present a series of 15 patients with cardiac support by awake VA-ECMO, techniques, parameters, complications, and treatment results. Results Enrolled in this study, including 15 patients: 04 NSTEMI (very high-risk PCI), 09 Myocarditis, 02 electrical storm; Age 53,2 ± 19,5. The local anesthesia, mild sedation when the patient is anxious; performed vascular access with DSA system. The duration from the patient's admission to ECMO was 3,8 ± 2,9 (day) and awake VA-ECMO 3,1 ± 2,5 (day) (min to max: 1 – 6). The CO of ECMO: 1,6 ± 1,2 (l/ph); 03 patients with continuous renal replacement therapy. A patient with acute thrombosis of the lower extremity had successful percutaneous thrombectomy; fifteen patients were successfully weaned from ECMO (100%), no patient death in 7 days, and 02 patient deaths in 30 days. Conclusion Awake VA-ECMO can be performed safety on the cardiac patient when waiting for recovery or management.