CLINICAL OUTCOMES OF VA ECMO IN REFRACTORY CARDIOGENIC SHOCK: A RETROSPECTIVE STUDY AT CHO RAY HOSPITAL

Hữu Chinh Trần, Văn Chiêu Lý, Anh Tuấn Vương, Trọng Luật Nguyễn, Hữu Hoàng Lê, Song Toàn Trần, Đại Cường Trần, Phi Hùng Trương, Quý Đức Đặng, Văn Sỹ Hoàng

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Abstract

Objective: This study aimed to evaluate the clinical efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) in patients with refractory cardiogenic shock unresponsive to medical treatment at the Cardiology Department, Cho Ray Hospital, from 2022 to 2024. Methods: A retrospective study was conducted on 100 patients with refractory cardiogenic shock unresponsive to medical interventions within 6 hours. Data analyzed included hemodynamic parameters, blood lactate levels before and after ECMO intervention, and in-hospital survival rates. Results: From February 2022 to June 2024, 100 patients (58% female) underwent VA ECMO, with a median age of 35 years. The main etiologies were myocarditis (65%), acute myocardial infarction (11%), and drug intoxication (10%). Before ECMO, the mean arterial pressure was 55 mmHg, and blood lactate level was 4.2 mmol/L, reflecting severe deterioration. After 24 hours of ECMO, survivors showed significant improvement: heart rate decreased by 27 bpm, systolic blood pressure increased by 22 mmHg, and blood lactate levels reduced by 1.9 mmol/L. The highest in-hospital survival rate was observed in the drug intoxication group (80%), while the acute myocardial infarction group had the lowest rate (9%). Conclusion: VA ECMO is an effective intervention for severe cardiogenic shock; however, meticulous post-intervention management is essential to minimize complications and optimize outcomes

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References

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