Background
Cardiogenic shock refractory to conventional therapy has very high mortality and limited
support options. New technology with peripherally inserted CentriMag (Levitronix LLC,
Waltham, MA) extracorporal membrane oxygenation (ECMO) may have the potential to significantly
improve survival in these critically ill patients. Outcomes of the first 10 patients
to receive this device at our institutions are presented.
Methods
Patients were identified by their primary physicians and evaluated by our Mechanical
Circulatory Support Team. CentriMag ECMO was initiated at the bedside using sterile
percutaneous cannulation of femoral vessels. Patients were admitted to the Heart and
Vascular Intensive Care Unit, with care managed by regular nursing staff with special
training.
Results
The patients (5 men, 5 women) were a mean age of 45 ± 18 years, had a mean left ventricular
ejection fraction of 30%, and a mean lactate level of 9 mmol/liter. All patients met
criteria for shock refractory to medical therapy, but the etiology varied. Average
duration of ECMO support was 5.8 ± 4 days. Survival was 60%. There were no major complications
directly related to the device and no equipment malfunctions.
Conclusions
The peripherally inserted CentriMag ECMO was easy to insert, functioned without mechanical
error, and significantly reduced expected mortality in critically ill patients. Further
research will be necessary to develop standardized algorithms and gain more experience,
but this new technology has promising potential.
Keywords
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Article info
Publication history
Published online: October 19, 2009
Identification
Copyright
© 2010 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
