PMID- 27867655
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 8
IP  - 10
DP  - 2016 Oct
TI  - Veno-arterial extracorporeal membrane oxygenation (VA ECMO) in postcardiotomy 
      cardiogenic shock: how much pump flow is enough?
PG  - E1444-E1448
AB  - Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery 
      associated with a poor prognosis: veno-arterial extracorporeal membrane 
      oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and 
      lung function, though it is associated with unsatisfactory results. Few studies 
      have identified reliable predictors of poor prognosis early in the course of 
      extracorporeal support. A recent study showed the strong prognostic power of 
      urine output in the first 24 hours of VA ECMO in predicting early and late 
      mortality of PCCS. Urine output is a commonly collected parameter in all 
      intensive care units (ICU) and has a defined role in the diagnosis of acute 
      kidney injury (AKI) and is inexpensive. These findings offer the possibility to 
      summarize some aspects regarding the adequacy of extracorporeal support early in 
      the course of cardiogenic shock and to shed light about cardio-renal interactions 
      in ECMO patients. Finally, it is our opinion that a timely implantation of 
      mechanical circulatory support in post cardiotomy shock should be considered if 
      systemic perfusion is not ensured by low or medium dose inotropic support and 
      intra-aortic balloon counterpulsation.
FAU - Pappalardo, Federico
AU  - Pappalardo F
AD  - Department of Anesthesia and Intensive Care, San Raffaele Scientific Institute, 
      Milan, Italy.
FAU - Montisci, Andrea
AU  - Montisci A
AD  - Department of Anesthesia and Intensive Care, Sant'Ambrogio Clinical Institute, 
      San Donato Hospital Group, Milan, Italy.
LA  - eng
PT  - Comment
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
CON - Crit Care Med. 2016 Mar;44(3):531-8. PMID: 26562346
PMC - PMC5107499
OTO - NOTNLM
OT  - Extracorporeal membrane oxygenation (ECMO)
OT  - cardiac surgery
OT  - cardiogenic shock
OT  - multiple organ failure
COIS- The authors have no conflicts of interest to declare.
EDAT- 2016/11/22 06:00
MHDA- 2016/11/22 06:01
PMCR- 2016/10/01
CRDT- 2016/11/22 06:00
PHST- 2016/11/22 06:00 [entrez]
PHST- 2016/11/22 06:00 [pubmed]
PHST- 2016/11/22 06:01 [medline]
PHST- 2016/10/01 00:00 [pmc-release]
AID - jtd-08-10-E1444 [pii]
AID - 10.21037/jtd.2016.10.01 [doi]
PST - ppublish
SO  - J Thorac Dis. 2016 Oct;8(10):E1444-E1448. doi: 10.21037/jtd.2016.10.01.