{"id":286,"date":"2015-05-11T14:15:26","date_gmt":"2015-05-11T14:15:26","guid":{"rendered":"\/cardiovascular-insights\/?p=286"},"modified":"2016-09-19T18:11:03","modified_gmt":"2016-09-19T18:11:03","slug":"early-ecmo-referral-for-better-patient-prognosis","status":"publish","type":"post","link":"https:\/\/www.uchealth.com\/cardiovascular-insights\/early-ecmo-referral-for-better-patient-prognosis\/","title":{"rendered":"Early ECMO Referral for Better Patient Prognosis"},"content":{"rendered":"

Used for decades as a tool in the treatment arsenal for cardiogenic shock, extracorporeal membrane oxygenation (ECMO) is being taken to a whole new level in about 100 shock programs in the United States, where unprecedented survival rates are beginning to be achieved.1<\/sup> The best outcomes are seen when referra(ECMO) is being taken to a whole new level in about 100 shock programs in the United States, where unprecedented survival rates are beginning to be achieved to advanced cardiac medical therapies, such as ECMO, occurs earlier, rather than later, for certain patients.<\/p>\n

Ideal candidates are in generally good health; the whole body has to make it through and have the capacity to heal. Feldman elaborates, \u201cFor instance, a patient who had a severe heart attack while at work, or one with suddenly worsened heart failure, or a healthy adult who was in a car accident; these people have a good chance of surviving and leading a long life if they receive ECMO, possibly paired with other treatments like dialysis, in a timely fashion. These therapies do the work, giving damaged organs a chance to rest and heal. For patients like these, referral for ECMO can\u2019t occur too soon.\u201d<\/p>\n

According to David Feldman, MD, PhD<\/a>, director of clinical services at the University of Cincinnati Medical Center Heart, Lung and Vascular Institute, \u201cFor patients with heart failure, physicians need to keep the criteria for cardiogenic shock on their radar and recognize the signs early.\u201d<\/p>\n

\u201cThe elegant simplicity of using ECMO for cardiogenic shock is that you take the failing heart out of the equation and support the patient\u2019s circulation and organs while you attempt to correct the life threatening cardiac problem,\u201d says Louis B. Louis IV, MD, FACS, associate professor, and chief of cardiac surgery. \u201cWith a patient on ECMO, you have the luxury of time to make a thoughtful decision, and once you decide to intervene, you are dealing with a patient whose organs are functioning instead of failing.\u201d<\/p>\n

With technological advances and refinements in ECMO protocols at quaternary care centers like the one at the University of Cincinnati Medical Center, even the most challenging cases may survive. Feldman notes, \u201cWith ECMO, we can bring a patient back even after 30 minutes of resuscitative efforts.\u201d However, damage to the heart or other organ systems may yield a poor quality of life, with some patients requiring heart transplant or long-term hemodialysis.2<\/sup> As with other types of advanced care, appropriate patient selection and good timing are key to achieving the best outcomes.<\/p>\n

Diagnostic Criteria for Cardiogenic Shock3<\/sup><\/strong><\/p>\n