PMID- 30279917
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1878-5409 (Print)
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 18
IP  - 2
DP  - 2018 Aug
TI  - Promising method for management of venoarterial extracorporeal membrane 
      oxygenation: A case of severe heart failure successfully stabilized by 
      "high-flow/vasodilation method".
PG  - 81-84
LID - 10.1016/j.jccase.2018.05.002 [doi]
AB  - We report the case of a 58-year-old man with dilated cardiomyopathy who was 
      hospitalized because of worsening heart failure. As his symptoms were refractory 
      even with the administration of inotropes, he was given peripheral venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) upon transfer to our hospital. On 
      admission, serum creatinine was 2.62 mg/dL and total bilirubin 10.8 mg/dL. The 
      cannulas inserted were 16-Fr for infusion and 21-Fr for drainage. When the blood 
      flow was increased to 2.14 L/min/m(2) to improve organ dysfunction, the aortic 
      valve became continuously close with the mean arterial pressure of 85 mmHg. 
      Therefore, we administrated vasodilators to decrease mean arterial pressure, or 
      left ventricular afterload, which achieved opening aortic valve continuously. 
      After the cannula sizes were scaled up to 18Fr for infusion and 24Fr for drainage 
      to gain further blood flow, the aortic valve opened continuously and mean 
      pulmonary pressure decreased. Our strategy to maintain adequate flow rate of 
      VA-ECMO using vasodilator, "high-flow/vasodilation method", achieved hemodynamic 
      stability. Additionally, the concentration of serum creatinine and total 
      bilirubin gradually decreased to within the normal range, although the patient 
      succumbed 58 days after transfer to our hospital. <Learning objective: 
      Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is often used as a 
      first-line mechanical circulatory support in patients with severe heart failure. 
      However, its management is difficult and not established. We discuss the efficacy 
      and potency of our "high-flow/vasodilation method" in the management of 
      VA-ECMO.>.
FAU - Kondo, Toru
AU  - Kondo T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Sawamura, Akinori
AU  - Sawamura A
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Okumura, Takahiro
AU  - Okumura T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Kano, Naoaki
AU  - Kano N
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Morimoto, Ryota
AU  - Morimoto R
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Watanabe, Naoki
AU  - Watanabe N
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Hiraiwa, Hiroaki
AU  - Hiraiwa H
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Kuwayama, Tasuku
AU  - Kuwayama T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Sugiura, Yuki
AU  - Sugiura Y
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Haga, Tomoaki
AU  - Haga T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Yamaguchi, Shogo
AU  - Yamaguchi S
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Fukaya, Kenji
AU  - Fukaya K
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Yokoi, Tsuyoshi
AU  - Yokoi T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Fujimoto, Kazuro
AU  - Fujimoto K
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Mutsuga, Masato
AU  - Mutsuga M
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Yoshizumi, Tomo
AU  - Yoshizumi T
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Matsuda, Naoyuki
AU  - Matsuda N
AD  - Emergency and Critical Care Medicine, Nagoya University Graduate School of 
      Medicine, Nagoya, Japan.
FAU - Usui, Akihiko
AU  - Usui A
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Murohara, Toyoaki
AU  - Murohara T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
LA  - eng
PT  - Case Reports
DEP - 20180614
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC6149648
OTO - NOTNLM
OT  - Dilated cardiomyopathy
OT  - Extracorporeal membrane oxygenation
OT  - Heart failure
OT  - Management
EDAT- 2018/10/04 06:00
MHDA- 2018/10/04 06:01
PMCR- 2018/06/14
CRDT- 2018/10/04 06:00
PHST- 2018/03/10 00:00 [received]
PHST- 2018/04/18 00:00 [revised]
PHST- 2018/05/07 00:00 [accepted]
PHST- 2018/10/04 06:00 [entrez]
PHST- 2018/10/04 06:00 [pubmed]
PHST- 2018/10/04 06:01 [medline]
PHST- 2018/06/14 00:00 [pmc-release]
AID - S1878-5409(18)30043-4 [pii]
AID - 10.1016/j.jccase.2018.05.002 [doi]
PST - epublish
SO  - J Cardiol Cases. 2018 Jun 14;18(2):81-84. doi: 10.1016/j.jccase.2018.05.002. 
      eCollection 2018 Aug.