Evidence map›Paper›PMID 34922438›Full record

ArticleBMC anesthesiology2021

Secondary left heart failure occurred during VA-ECMO assistance for severe residual pulmonary hypertension after pulmonary endarterectomy: a case report.

Feng Long, Ming Luo, Zhen Qin, Bo Wang, Ronghua Zhou

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Feng Long *Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, PR China.
Ming Luo *Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, PR China.
Zhen QinDepartment of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, PR China.
Bo WangDepartment of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, PR China.
Ronghua ZhouDepartment of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, 610041, PR China. wr.zhou@hotmail.com.ORCID 0000-0002-4069-0136
Sichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients of chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides full haemodynamic support. However, during a rescue treatment of VA-ECMO for patients with difficulty weaning from cardiopulmonary bypass, a significantly increase left ventricular afterload through retrograde infusion of arterialized blood into the descending aorta may occur. CASE PRESENTATION: We report a 70-year-old man who suffered severe residual pulmonary hypertension following pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Preoperative echocardiogram showed a dilated and poorly functioning right ventricle, as well as a small left heart with normal function (TAPES9.6 mm, LVEF64%, average E/E'11.94, lateral E'12.1 cm/s, tricuspid regurgitation velocity 2.5 m/s), while postoperative echocardiography revealed a significant decrease of whole ventricular function on postoperative day 1(TAPES4mm, LVEF28%, average E/E'15, lateral E'6.7 cm/s, tricuspid regurgitation velocity 4.1 m/s), indicating the patient developed severe secondary left ventricular dysfunction on the basis of right ventricular dysfunction, during VA-ECMO support. Then comprehensive measures were adopted, such as down-regulating VA-ECMO flow rate, adjusting respiratory parameters, using vasoactive drugs, as well as prostacyclin. Eventually, the pulmonary hypertension decreased to moderate degree, and the heart function improved gradually.

conclusionsIn the face of severe residual pulmonary hypertension and sencondary left ventricular dysfunction associated with VA-ECMO, comprehensive measures described above may facilitate recovery. ECMO flow titration to maintain relatively low flow rate is very important to not only maintain systemic perfusion, but also reduce left ventricular afterload and ensure pulsatile perfusion of pulmonary artery.

Indexed as

AgedEndarterectomyExtracorporeal Membrane OxygenationHeart FailureHumansHypertension, PulmonaryMaleTomography, X-Ray ComputedCardiopulmonary bypassChronic thromboembolic pulmonary hypertensionExtracorporeal membrane oxygenationHeart failurePulmonary endarterectomy

Identifiers

PMID34922438
PMCPMC8684250
OpenAlexW4200305320

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.