Table 3. Comparisons of patients with endocrine crisis and acute myocardial infarction rescued with ECMO support.
| PC (n = 4) | DK (n = 3) | TS (n = 5) | AMI (n = 80) | |
|---|---|---|---|---|
| Age, years (range) | 45.5 (25–65) | 26 (16–34) | 40.4 (33–47) | 53.8 (31–65) |
| Male sex, n (%) | 3 (75) | 1 (33.3) | 3 (60) | 75 (94) |
| CPR, n (%) | 3 (75) | 2 (66) | 3 (60) | 55 (68.7) |
| ECMO duration, hour (range) | 102.5 (44.7–162.5) | 134.5 (0.9–381.8) | 82 (19–115.6) | 117 (5.4–475) |
| Ventilator support, day (range) | 14 (6–22) | 17.7 (1–51) | 10 (4–26) | 17.7 (1–95) |
| ICU length of stay, day (range) | 20.8 (6–28) | 18.0 (0–51) | 11.8 (5–26) | 21.6 (1–147) |
| Initial SOFA score (range) | 13 (9–18) | 13.7 (8–17) | 15 (13–18) | 10.4 (3–18) |
| MAP Day 1, mmHg (range) | 120 (101–137) | 97 (96–99) | 84 (63–101) | 74 (30–144) |
| Day 3 (range) | 121 (91–146) | 85 (84–86) | 113 (104–126) | 76 (920–112) |
| Day 6 (range) | 130 (116–145) | 99 (99) | 114 (93–132) | 88 (61–118) |
| Pre-ECMO IE, μg/kg/min | 28.3 | 56.8 | 35.5 | 21.4 |
| IE, day 3 (range) | 4.7 (2.1–7.0) | 32.4 (32.4) | 4.6 (0–18.4) | 24.1 (0–810) |
| IE, day 6 (range) | 1.4 (0–5.4) | 11.5 (11.5) | 0 (0) | 8.2 (0–31.8) |
| Patients using inotropes at day 6, n, (%) | 1 (25) | 1 (33%) | 0 (0%) | 50 (62.5%) |
| Initial CK, U/L (range) | 1572.5 (501–3796) | 225.3 (348–2576) | 714 (259–1574) | 2413 (41–28480) |
| CK day 3 (range) | 14589 (1528–47829) | 38.5 (38.5) | 8364.5 (515–4446) | 5808.4 (77–66274) |
| CK day 6 (range) | 22637 (530–13721) | 4496 (4496) | 501 (114–888) | 3163.4 (33–36621) |
| Initial CK-MB, U/L (range) | 86.2 (15–290) | 21.1 (14–32) | 42.6 (21–75) | 172 (4.2–2319.8) |
| CK-MB day 3 (range) | 3892 (90.9–10031) | 52.2 (52.2) | 53.5 (39.6–64.6) | 132.1 (1.5–1782) |
| CK-MB day 6 (range) | 66 (15.7–207) | 26 (26) | 45.1 (40.7–49.4) | 50.4 (1.2–308.9) |
| Initial Tn-I, μg/L (range) | 37.0 (.9–79) | 0.58 (0.5–0.7) | 0.35 (0.02–1.1) | 19 (0.01–100) |
| Tn-I day 3 (range) | 16.1 (9.4–24.4) | 0.4 (0.4) | 1.2 (0.5–1.8) | 37.7 (0.44–94) |
| Tn-I day 6 (range) | 2.2 (1.26–3.1) | Not available | Not available | 16.1 (0.31–33) |
| Lactate in 24 h, mmol/L (range) | 10.3 (8.7–11) | 6.25 (5.0–7.5) | 9.6 (3.5–12) | 8.9 (1–35) |
| Dialysis patients, n | 3 | 1 | 1 | 36 |
| IABP (at implantation) | 2 | 1 | 1 | 25 (32%) |
| Bilirubin day 3, mg/dL (range) | 1.3 (1.0–1.9) | 0.9 (0.9) | 10.6 (2.0–24.8) | 2.5 (0.4–12.2) |
| Bilirubin day 6 (range) | 1.7 (1.4–1.8) | 5.5 (5.5) | 19.5 (5.67–26.9) | 3.5 (0.6–21.3) |
| LVEF day 2, % (range) | 37.7 (30–43) | 54 (54) | 24 (20–40) | 33 (7–68) |
| LVEF day 6, % (range) | 61 (50–67) | 62 (62) | 55 (38–64) | 37.4 (18–65) |
| Weaned off ECMO, (%) | 4 (100%) | 2 (66.7%) | 4 (80%) | 56 (70%) |
| Complications | ||||
| Limb ischemia | 2 | 1 | 0 | 6 |
| Massive GI bleeding | 0 | 1 | 2 | 1 |
| Corneal erosion | 0 | 0 | 1 | 0 |
| ARDS/Pneumonia | 0 | 1 | 0 | 8 |
| Reinstitution of ECMO | 1 | 0 | 0 | 1 |
| Severe brain insult | 23 | |||
| Further intervention | ||||
| CABG, n | 0 | 0 | 0 | 26 |
| Repair VSD/wall, n | 0 | 0 | 0 | 4 |
| VAD, n | 0 | 0 | 0 | 3 |
| Heart transplantation, n | 0 | 0 | 0 | 1 |
| Adrenalectomy, n | 3 | 0 | 0 | 0 |
| Cause of mortality | ||||
| Sepsis-related MOF | 0 | 1 | 0 | 7 |
| Hepatic failure, MOF | 0 | 0 | 1 | 0 |
| Cardiogenic shock | 0 | 1 | 1 | 28 |
| Brain death | 0 | 0 | 0 | 3 |
| ARDS | 0 | 0 | 0 | 2 |
| Survival to discharge (%) | 4 (100%) | 1 (33.3%) | 3 (60%) | 40 (50%) |
| Survivors with CPC I, n (%) | 4 (100% ) | 1 (100%) | 2 (66.7%) | 32 (80%) |
Abbreviations: AMI: acute myocardial infarction; ARDS: acute respiratory distress syndrome; CABG: coronary artery bypass surgery; CK: creatine kinase; CPC: cerebral performance category; CPR: cardiac pulmonary resuscitation; DK: diabetic ketoacidosis; GI: gastrointestinal; IABP: intra-aortic balloon pumping; ICU: intensive care unit; IE: inotropic equivalents; LVEF: left ventricular ejection fraction; MAP, mean arterial pressure; MOF: multiple organ failure; PC: pheochromocytoma crisis; SOFA: sepsis-related organ failure assessment; Tn-I: troponin-I, TS: thyroid storm; VAD: ventricular assist device; VSD: ventricular septal defect.