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Extracorporeal life support for massive pulmonary embolism
Paul Maggio1, Mark Hemmila, Jonathan Haft
1Department of Surgery, University of Michigan Medical Center, MI 48109, USA. pmaggio@umich.edu
The Journal of Trauma
|April 7, 2007
Summary
Extracorporeal life support (ECLS) offers a chance for survival in patients with massive pulmonary embolism, a condition often fatal due to heart and lung failure. This study shows ECLS can improve outcomes for critically ill patients.
Area of Science:
- Cardiology
- Pulmonology
- Critical Care Medicine
Background:
- Massive pulmonary embolism (PE) is a life-threatening condition leading to acute, irreversible pulmonary and cardiac failure.
- Extracorporeal life support (ECLS) has been utilized for cardiopulmonary failure management since 1988.
- This review examines institutional experience with ECLS in managing massive PE.
Purpose of the Study:
- To evaluate the efficacy and outcomes of using ECLS in patients with massive pulmonary embolism.
- To assess the survival rates and complications associated with ECLS for massive PE.
Main Methods:
- A retrospective review of all patients receiving ECLS for massive pulmonary embolism between January 1992 and December 2005.
- Data extraction from patient records, including demographics, clinical status, ECLS parameters, and outcomes.
Main Results:
- Twenty-one patients received ECLS for massive PE; all were critically ill, requiring vasoactive drugs, and experiencing hypoxia or acidemia.
- Nineteen patients received venoarterial bypass, and two received venovenous bypass.
- The overall survival rate was 62% (13/21), with catastrophic neurologic events being the most common cause of mortality.
Conclusions:
- Emergent ECLS can significantly improve the prognosis for patients with massive pulmonary embolism.
- ECLS should be considered in the management algorithm for unstable patients with massive PE.
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