Veno-Arterial Extracorporeal Membrane Oxygenation for Cardiac Arrest Related to Massive Pulmonary Embolism: A Systematic Review

Scott, J.; Vender, Robert L.; Pettigrew, S.; Roth, Scott L.; Desai, P.B.; Gordon, Margaret Jane; Marchetti, N.; Cohen, Goodman; Bashir, Riyaz; Panaro, J.; Moores, LK; Criner, GJ; Rali, Parth

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6064

Cited by 1 publication

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“…61 Furthermore, patients who received systemic thrombolysis prior to ECMO initiation did not have a higher risk of death, demonstrating that these therapies should not be mutually exclusive and can be used in a complementary manner when necessary. 61…”

Section: Surgical Management Of High-risk Pementioning

confidence: 98%

“…A systematic review of 301 patients receiving VA ECMO support for high-risk PE-associated cardiac arrest demonstrated that 61% of patients survived to discharge, and that cannulation for ECMO during active CPR was associated with a sixfold higher risk of death. 61 Furthermore, patients who received systemic thrombolysis prior to ECMO initiation did not have a higher risk of death, demonstrating that these therapies should not be mutually exclusive and can be used in a complementary manner when necessary. 61…”

Section: Surgical Management Of High-risk Pementioning

confidence: 98%

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Advanced Treatment of Hemodynamically Unstable Acute Pulmonary Embolism and Clinical Follow-up

Fulton,

Bashir,

Weinberg

et al. 2023

Semin Thromb Hemost

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High-risk acute pulmonary embolism (PE), defined as acute PE associated with hemodynamic instability, remains a significant contributor to cardiovascular morbidity and mortality in the United States and worldwide. Historically, anticoagulant therapy in addition to systemic thrombolysis has been the mainstays of medical therapy for the majority of patients with high-risk PE. In efforts to reduce the morbidity and mortality, a wide array of interventional and surgical therapies has been developed and employed in the management of these patients. However, the most recent guidelines for the management of PE have reserved the use of these advanced therapies in scenarios where thrombolytic therapy plus anticoagulation are unsuccessful. This is due largely to the lack of prospective, randomized studies in this population. Stemming from this, the approach to treatment of these patients varies widely depending on institutional experience and resources. Furthermore, morbidity and mortality remain unacceptably high in this population, with estimated 30-day mortality of at least 30%. As such, development of a standardized approach to treatment of these patients is paramount to improving outcomes. Early and accurate risk stratification in conjunction with a multidisciplinary team approach in the form of a PE response team is crucial. With the advent of novel therapies for the treatment of acute PE, in addition to the growing availability of and familiarity with mechanical circulatory support systems, such a standardized approach may now be within reach.

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Section: Surgical Management Of High-risk Pementioning

confidence: 98%

Section: Surgical Management Of High-risk Pementioning

confidence: 98%