Influences of V-A Mode Assisted ECMO Combined with Intra-Aortic Balloon Counterpulsation on Disease Outcome and Troponin Level in Patients with Acute Fulminant Myocarditis

Authors

  • Zhiyong Yuan Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Xiaoning Han Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Fuhua Wang Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Yajun Jing Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Ying Liu Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Weigui Zhou Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China
  • Jinyan Xing Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China

DOI:

https://doi.org/10.59958/hsf.7573

Keywords:

vein-artery mode, extracorporeal membrane oxygenation, intra-aortic balloon counterpulsation, acute fulminant myocarditis, disease outcome, troponin

Abstract

Introduction: The acute fulminant myocarditis (AFM) is a special type of myocarditis, characterized by rapid onset, progression with abnormal hemodynamics causing high mortality. The combination of extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon counterpulsation (IABP) in these cases have improved the acute phase attacks resulting in increased survival of the effected individuals. To observe the effect of vein-artery (V-A) mode assisted ECMO combined with IABP on the disease outcomes and troponin level in patients with acute fulminant myocarditis (AFM). Methods: A total of 45 patients with AFM were admitted to our hospital from January 2016 to December 2021, they were divided into group A (21 patients, receiving traditional treatment) and group B (24 patients, receiving V-A mode assisted ECMO and IABP based on traditional treatment) according to the treatment plan. The hypersensitive troponin (hs-cTnI), B-type natriuretic peptide (BNP), arterial blood gas analysis index, multiple organ dysfunction score (MODS), simplified acute physiology score II (SAPS II), cardiac ultrasound index, and disease outcomes were compared between the two groups. Results: After treatment, the hs-cTnI, BNP, blood lactic acid, MODS score and SAPS score in both groups were lower than before treatment (p < 0.05), the arterial oxygen saturation (SaO2), left ventricular ejection fraction (LVEF) and cardiac index (CI) was higher than before treatment (p < 0.05), the hs-cTnI, BNP, blood lactic acid, MODS score and SAPS Ⅱ score in group B were lower than  group A (p < 0.05), SaO2, LVEF and CI was higher than group A (p < 0.05). The in-hospital mortality of group B (9.52%, 2/21) was lower than group A (45.83%, 11/24) (χ2 = 7.188, p = 0.007). Among the recovered discharged patients, the length of stay in group B (19 patients, 14.42 ± 4.59 days) was shorter than group A (13 patients, 18.34 ± 5.72 days) (t = 2.147, p = 0.040). Conclusions: V-A mode assisted ECMO combined with IABP can improve the condition and arterial blood gas analysis index and cardiac function of AFM patients, alleviate myocardial injury, reduce mortality in the hospital, and shorten the hospitalization time of the recovered patients.

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Published

2024-09-10

How to Cite

Yuan, Z. ., Han, X. ., Wang, F. ., Jing, Y. ., Liu, Y. ., Zhou , W. ., & Xing, J. (2024). Influences of V-A Mode Assisted ECMO Combined with Intra-Aortic Balloon Counterpulsation on Disease Outcome and Troponin Level in Patients with Acute Fulminant Myocarditis. The Heart Surgery Forum, 27(9), E1003-E1009. https://doi.org/10.59958/hsf.7573

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