J Med Life Sci > Volume 15(2); 2018 > Article
Journal of Medicine and Life Science 2018;15(2):108-111.
DOI: https://doi.org/10.22730/jmls.2018.15.2.108    Published online January 3, 2019.
급성심근경색 환자에게 적용된 정맥-정맥 체외막산화기의 임상 효과
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Clinical effects of veno-venous extra-corporeal membrane oxygenation for acute myocardial infarction
Su wan Kim, Gil Myeong Seong, Jae-Geun Lee
School of medicine, Jeju National University
Jeju National University Hospita
Correspondence:  Jae-Geun Lee, Email: tedljg@naver.com
Abstract
Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-artery ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.
Key Words: Acute, myocardial, infarction, Heart, failure


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