ECMO in Circulatory Failure
1Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan, Taiwan
Despite the efficacy of heart-failure (HF) therapy, patients may still decompensate and require hospitalization. In addition to the gap between guidelines and clinical practice, this highlights the need for a multidisciplinary approach to the management of HF. The third European Mechanical Circulatory Support Summit presented the latest trials and trends in conservative therapy of end-stage HF (ESHF) and the alternative options over a ten-session program. The meeting covered topics such as epidemiological trends, different HF registries and guidelines for ESHF therapy. In addition to databases and HF trials, the presenters discussed the integration of multiple biomarkers in HF stratification, biological solution and embryonic stem cells for HF therapy, up-to-date myocardial recovery and the surgical aspects of ESHF treatment. Therapeutic options following ECMO for the shock as well as resucitation. Short-term left ventricular support were discussed. ECMOmoffers a rapid deplyment and biovenricualr as well as lun support for teh circualtory collpase. The easy conversion module and the safety are gradually accepted globally. The number to the ECMo n cardiogenic shock are signifcantly increasing the recent 5 years. It had been 300% increase compared to the data in 2008. Two special issues remain further discussion. Left ventricualr unloading is still a controvesrail issue, and what kind of the decompression methodology is always a debatable topic in the interantional conference or debate. The brain recovery or prediction in the CPR status is also a challenging problem.
The Bridge-to-bridge and device selection; VAD-weaning criteria; patient–device matching (short-term device), cardiac transplantation following short-term suppor are the following important issue remain fruther investigation.