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Publication
ECMO como terapia em choque cardiogénico Pós-EAM
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Advisor(s)
Abstract(s)
A oxigenação por membrana extracorporal é um dispositivo de assistência circulatória mecânica de curta duração utilizado em doentes com disfunção cardíaca e/ou pulmonar grave refratários à terapêutica convencional. O seu funcionamento implica a canulação de dois grandes vasos (inflow e outflow), uma bomba centrífuga e um oxigenador. Existem duas modalidades de oxigenação por membrana extracorporal, no ECMO VenoVenoso o sangue é drenado e entregue apenas por veias, permitindo apenas o suporte pulmonar, enquanto no ECMO VenoArterial a drenagem sanguínea é efetuada através de uma veia e entregue numa
artéria, garantindo assim o suporte cardiopulmonar. O presente estudo apresenta o relato de um caso
clínico de um paciente do sexo masculino com 56 anos que foi transportado para uma unidade hospitalar por um episódio de dor torácica intensa há 24h e sensação de dispneia súbita. O doente foi transferido para uma Unidade de Cuidados Intensivos de Cardiotorácica, afim da colocação de ECMO VenoArterial por choque cardiogénico pós enfarte agudo do miocárdio como ponte para decisão terapêutica. A oxigenação por membrana extracorporal pode ser utilizada em vários contextos clínicos desde a estabilização e recuperação do órgão alvo, até como ponte de decisão para transplante cardíaco ou colocação de um dispositivo de assistência circulatória mecânica de longa duração.
Extracorporeal membrane oxygenation is a shortterm mechanical circulatory assist device used in patients with severe cardiac and/or pulmonary dysfunction refractory to conventional therapy. Its operation involves the cannulation of a vein (inflow) and an artery (outflow), one centrifugal pump and one oxygenator. There are two modalities of extracorporeal membrane oxygenation, in the ECMO-venovenous blood is drained and delivered only through veins, allowing only pulmonary support whereas in the ECMO-venoarterial blood is drained through a vein and delivered in one artery, thus ensuring cardiopulmonary support. The present study presents the report of a clinical case of a 56-year-old male patient who was transported to a hospital for an episode of severe chest pain 24 hours ago and a sensation of sudden dyspnea. The patient was transferred to the Cardiothoracic Intensive Care Unit for placement of ECMO-venoarterial due to cardiogenic shock after acute myocardial infarction as a bridge for therapeutic decision. Extracorporeal membrane oxygenation can be used in several clinical contexts, from stabilization and recovery of the target organ, to as a decision bridge for heart transplantation or placement of a longterm mechanical circulatory assist device.
Extracorporeal membrane oxygenation is a shortterm mechanical circulatory assist device used in patients with severe cardiac and/or pulmonary dysfunction refractory to conventional therapy. Its operation involves the cannulation of a vein (inflow) and an artery (outflow), one centrifugal pump and one oxygenator. There are two modalities of extracorporeal membrane oxygenation, in the ECMO-venovenous blood is drained and delivered only through veins, allowing only pulmonary support whereas in the ECMO-venoarterial blood is drained through a vein and delivered in one artery, thus ensuring cardiopulmonary support. The present study presents the report of a clinical case of a 56-year-old male patient who was transported to a hospital for an episode of severe chest pain 24 hours ago and a sensation of sudden dyspnea. The patient was transferred to the Cardiothoracic Intensive Care Unit for placement of ECMO-venoarterial due to cardiogenic shock after acute myocardial infarction as a bridge for therapeutic decision. Extracorporeal membrane oxygenation can be used in several clinical contexts, from stabilization and recovery of the target organ, to as a decision bridge for heart transplantation or placement of a longterm mechanical circulatory assist device.
Description
Keywords
ECMO Enfarte agudo do miocárdio Choque cardiogénico ECMO Acute myocardial infarction Cardiogenic shock
Citation
JUSTINO, Vanessa [et al.] (2022) - ECMO como terapia de choque cardiogénico Pós-EAM. HIGEIA : Revista Científica da Escola Superior de Saúde Dr. Lopes Dias. ISSN 2184-5565. Ano IV, vol. 8, n.º 2, p. 27-35.
Publisher
IPCB. ESALD