Extracorporeal membrane oxygenation in adult patients with acute fulminant myocarditis : Clinical outcomes and risk factor analysis.

Abstract

Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO. The patients were divided into a survivor group and a nonsurvivor group. From atotal of 33patients, seven died in hospital. The survival rate was 78.7%. The following complications were observed during ECMO: 16cases of acute renal failure (48.4%), seven cases of sepsis (21.2%), six cases of pulmonary infection (18.1%), six cases of multiple organ failure (MOF; 18.1%), three cases of cerebral hemorrhage (9%), and four cases of limb ischemia (12.1%). Pre-ECMO cardiopulmonary resuscitation, high levels of lactic acid, high amounts of blood transfusion during ECMO, renal failure, encephalorrhagia, gastrointestinal complications, lower-limb ischemia, high bilirubin levels, and MOF during ECMO were associated with unfavorable patient outcomes. ECMO is an effective auxiliary tool for treating acute fulminant myocarditis. Acute renal failure is the most common complication during ECMO. Improving tissue perfusion, reducing blood transfusions, and preventing acute kidney failure may improve patient outcomes.