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Chinese Journal of Medical Ultrasound (Electronic Edition) ›› 2017, Vol. 14 ›› Issue (04): 292-296. doi: 10.3877/cma.j.issn.1672-6448.2017.04.011

Special Issue:

• Cardiovascular Ultrasound • Previous Articles     Next Articles

The value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation in patients with cardiogenic shock

Zhengchun Yu1, Xiaojing Ma1,(), Juan Xia1, Jing Li1   

  1. 1. Department of Ultrasonography, Wuhan Asia Heart Hospital, Wuhan 430022, China
  • Received:2016-07-01 Online:2017-04-01 Published:2017-04-01
  • Contact: Xiaojing Ma
  • About author:
    Corresponding author: Ma Xiaojing, Email:

Abstract:

Objective

To investigate the value of echocardiography in monitoring the treatment of extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock (CS).

Methods

A total of 21 patientss were included into the present study, who were treated by ECMO due to CS in Wuhan Asia Heart Hospital from January 2013 to December 2015. The left ventricular ejection fraction (LVEF) and Tei index were measured by echocardiography before, in the middle of (flow reduced to one half) and immediately after the process of ECMO. The systolic blood pressure (SBP) and the arterial oxygen saturation (SaO2) were also recorded, and the parameters were compared. The differences of LVEF, Tei index, SBP and SaO2 among different phases of ECMO were compared by using one-way ANOVA and LSD-t test. The differences of heart beat rate, the diameters of left ventricle, diameters of inferior vena cava, subsidence rate of inferior vena cava, pulmonary capillary wedge pressure and central venous pressure among different phases of ECMO were also compared by paired-samples t test.

Results

Compared with the pre-ECMO level, the LVEF increased during and immediately after the ECMO (t=31.952, 59.404, both P<0.01), while the Tei index decreased significantly (t=34.406, 58.969, both P<0.01). Compared with the pre-ECMO level, the SBP, SaO2 and subsidence rate of inferior vena cava all increased during and immediately after the ECMO, while the diameter of left ventricle, pulmonary capillary wedge pressure and central venous pressure all decreased significantly (t=7.382, 37.785, -11.286, 3.294, 13.923, 16.971, all P<0.01 or 0.05). In contrast, there was no significant change for the parameters of heart beat rate and diameter of inferior vena cava.

Conclusion

When treating CS patients with ECMO, the echocardiography can monitor the cardiac function effectively, and provide important parameters for the clinical doctors to estimate the ECMO efficacy and decide the weaning time.

Key words: Echocardiography, Extracorporeal membrane oxygenation, Cardiogenic shock

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