Fulminant myocarditis with multiple organ dysfunction treated by extracorporeal life support in ICU: report of 9 adult cases
10.3760/cma.j.cn114798-20210916-00704
- VernacularTitle:成人暴发性心肌炎体外生命支持治疗9例临床分析
- Author:
Jing GUO
1
;
Minwei ZHANG
;
Yaogui NING
Author Information
1. 厦门大学附属第一医院重症医学科，厦门361000
- Keywords:
Fulminant myocarditis;
Cardiogenic shock;
Intra-aortic balloon pump (IABP);
Extracorporeal membrane oxygenation (ECMO)
- From:
Chinese Journal of General Practitioners
2022;21(2):141-146
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical experience in the treatment of fulminant myocarditis with multiple organ dysfunction using extracorporeal life support in the ICU.Methods:Clinical data of 9 adult cases of fulminant myocarditis complicated with multiple organ dysfunction admitted in ICU from January 2019 to October 2020 were retrospectively analyzed.Results:All patients received immunoregulatory and antiviral therapy; mechanical ventilation and renal replacement treatment were performed. Extracorporeal life support was also applied, including 1 case receiving intra-aortic balloon pump (IABP) support, and 6 cases receiving IABP and venous-arterial extracorporeal membrane oxygenation (VA-ECMO). In 6 cases with ECMO, the SpO 2(100.0±0)%, ScvO 2(78.7±3.9)%, hsTnI [10.0(2.2,31.8)mg/ml], oxygenation index[437.0(326.5,450.8)], lactic acid [(1.5±0.5)mmol/L], BE(-1.1±1.9)and LVEF(53.5±12.6)% were significantly improved 5 days after treatment compared with before [(98.0±1.4)%,(61.9±4.3)%,27.1(16.6,50.0)mg/ml,159.7(70.3,190.9),(6.4±3.4)mmol/L,(-10.3±4.6),(29.0±11.1)%]( t=-3.46, -9.74; Z=-1.99, -4.89; t=3.63, -5.84, -3.33; P<0.05). Eight patients were discovered and discharged, and one patient died. Conclusion:Fulminant myocarditis develops rapidly, integrated treatment based on extracorporeal mechanical life support and immunomodulatory therapy can improve the outcome of patients in the ICU.
