期刊
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
卷 162, 期 3, 页码 992-1001出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jtcvs.2020.10.151
关键词
mitochondrial transplantation; ischemia reperfusion injury; ECMO; pediatric cardiac surgery
资金
- Richard A. and Susan F. Smith President's Innovation Award
- Sidman Family Foundation
- Michael B. Rukin Charitable Foundation
- Kenneth C. Griffin Charitable Research Fund
- Bulens Family Fund
The pilot study showed that autologous mitochondrial transplantation with revascularization was associated with higher success rate of ECMO separation, better ventricular strain, shorter time to functional recovery, and lower incidence of cardiovascular events in pediatric patients with severe refractory cardiogenic shock after ischemia-reperfusion injury requiring postcardiotomy ECMO.
Objectives: To report outcomes in a pilot study of autologous mitochondrial trans-plantation (MT) in pediatric patients requiring postcardiotomy extracorporeal membrane oxygenation (ECMO) for severe refractory cardiogenic shock after ischemia-reperfusion injury (IRI). Methods: A single-center retrospective study of patients requiring ECMO for post-cardiotomy cardiogenic shock following IRI between May 2002 and December 2018 was performed. Postcardiotomy IRI was defined as coronary artery compromise followed by successful revascularization. Patients undergoing revascularization and subsequent MT were compared with those undergoing revascularization alone (Control). Results: Twenty-four patients were included (MT, n = 10; Control, n = 14). Markers of systemic inflammatory response and organ function measured 1 day before and 7 days following revascularization did not differ between groups. Successful separation from ECMO-defined as freedom from ECMO reinstitution within 1 week after initial separation-was possible for 8 patients in the MT group (80%) and 4 in the Control group (29%) (P = .02). Median circumferential strain immediately following IRI but before therapy was not significantly different between groups. Immediately following separation from ECMO, ventricular strain was significantly better in the MT group (-23.0%; range, -20.0% to -28.8%) compared with the Control group (-16.8%; range, -13.0% to -18.4%) (P = .03). Median time to functional recovery after revascularization was significantly shorter in the MT group (2 days vs 9 days; P = .02). Cardiovascular events were lower in the MT group (20% vs 79%; P < .01). Cox regression analysis showed higher composite estimated risk of cardiovascular events in the Control group (hazard ratio, 4.6; 95% confidence interval, 1.0 to 20.9; P = .04) Conclusions: In this pilot study, MT was associated with successful separation from ECMO and enhanced ventricular strain in patients requiring postcardiotomy ECMO for severe refractory cardiogenic shock after IRI.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据