ECMO for fulminant myocarditis-induced cardiogenic shock yielded a 53% survival rate and reduced mean lactate from 5.43 to 1.52 mmol/L, despite a 90.3% complication rate.
In young adults with fulminant myocarditis-induced cardiogenic shock, ECMO provides effective physiological stabilization but is associated with a 47% in-hospital mortality and high rates of renal and infectious complications.
Absolute Event Rate: 0% vs 0%
Introduction: Fulminant myocarditis (FM) is an uncommon, life-threatening cause of refractory cardiogenic shock (CS), particularly in young adults. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a critical rescue therapy, yet clinical outcomes, particularly from Latin American centers, are not well-described. We aimed to describe the characteristics, physiological response, and outcomes of patients with FM-induced CS supported with ECMO at a high-volume center in Colombia. Methods: We conducted a retrospective, observational study of adult patients (≥18 years) receiving ECMO for FM-induced CS between February 2018 and August 2024 at Fundación Clínica Shaio. Data on demographics, baseline clinical severity, physiological parameters pre-ECMO, at 24 hours, and post-ECMO, in-hospital complications, and outcomes were extracted from an institutional registry. The primary outcome was in-hospital mortality. Artificial intelligence (AI) was utilized exclusively for translation and English language editing. Results: A total of 32 patients were included. The mean age was 37.5±12.0 years, and 17 (53.1%) were male. Patients presented with profound shock and multi-organ dysfunction, with a mean pre-ECMO left ventricular ejection fraction (LVEF) of 27.7%±17.9%, APACHE II score of 12.2±5.9, and SOFA score of 7.4±2.9. V-A ECMO was the predominant configuration (n=26, 81.25%). ECMO support led to effective correction of metabolic acidosis, with mean lactate decreasing from 5.43±4.2 mmol/L pre-ECMO to 1.52±0.7 mmol/L post-ECMO. The clinical course was marked by a high complication rate (n=28, 90.3%), most commonly renal (n=13, 41.9%) and infectious (n=12, 41.4%). Overall in-hospital mortality was 47% (n=15). Conclusions: In this single-center Latin American cohort, ECMO provided effective physiological stabilization for young adults with FM-induced CS. However, survival rate was 53% and the most frequent complications were acute kidney injury (AKI) and infections. These findings underscore that while ECMO is an indispensable rescue therapy, patient outcomes may be influenced by the subsequent multi-organ failure.
Cortes-Salinas et al. (Sun,) reported a other. ECMO for fulminant myocarditis-induced cardiogenic shock yielded a 53% survival rate and reduced mean lactate from 5.43 to 1.52 mmol/L, despite a 90.3% complication rate.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: