Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry
Abstract Background Human immunodeficiency virus (HIV) is associated with increased risk of heart failure via multiple mechanisms both in patients with and without access to highly active antiretroviral therapy (HAART). Limited information is available on outcomes among this population supported on...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-023-02191-8 |
| _version_ | 1797849916635086848 |
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| author | Matthew Laraghy James McCullough John Gerrard Andrie Stroebel James Winearls |
| author_facet | Matthew Laraghy James McCullough John Gerrard Andrie Stroebel James Winearls |
| author_sort | Matthew Laraghy |
| collection | DOAJ |
| description | Abstract Background Human immunodeficiency virus (HIV) is associated with increased risk of heart failure via multiple mechanisms both in patients with and without access to highly active antiretroviral therapy (HAART). Limited information is available on outcomes among this population supported on Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO), a form of temporary mechanical circulatory support. Methods We aimed to assess outcomes and complications among patients with HIV supported on VA ECMO reported to a multicentre registry and present a case report of a 32 year old male requiring VA ECMO for cardiogenic shock as a consequence of his untreated HIV and acquired immune deficiency syndrome (AIDS). A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry data from 1989 to 2019 was performed in HIV patients supported on VA ECMO. Results 36 HIV positive patients were reported to the ELSO Database who received VA ECMO during the study period with known outcomes. 15 patients (41%) survived to discharge. No significant differences existed between survivors and non-survivors in demographic variables, duration of VA ECMO support or cardiac parameters. Inotrope and/or vasopressor requirement prior to or during VA ECMO support was associated with increased mortality. Survivors were more likely to develop circuit thrombosis. The patient presented was supported on VA ECMO for 14 days and was discharged from hospital day 85. Conclusions A limited number of patients with HIV have been supported with VA ECMO and more data is required to ascertain the indications for ECMO in this population. HIV should not be considered an absolute contraindication to VA ECMO as they may have comparable outcomes to other patient groups requiring VA ECMO support. |
| first_indexed | 2024-04-09T18:51:54Z |
| format | Article |
| id | doaj.art-9dd79981e0234351bf1700dffdcf2414 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-09T18:51:54Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-9dd79981e0234351bf1700dffdcf24142023-04-09T11:26:32ZengBMCJournal of Cardiothoracic Surgery1749-80902023-04-011811710.1186/s13019-023-02191-8Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registryMatthew Laraghy0James McCullough1John Gerrard2Andrie Stroebel3James Winearls4Intensive Care, Gold Coast University HospitalIntensive Care, Gold Coast University HospitalInfectious Diseases and Immunology, Gold Coast University HospitalCardiothoracic Surgery, Gold Coast University HospitalIntensive Care, Gold Coast University HospitalAbstract Background Human immunodeficiency virus (HIV) is associated with increased risk of heart failure via multiple mechanisms both in patients with and without access to highly active antiretroviral therapy (HAART). Limited information is available on outcomes among this population supported on Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO), a form of temporary mechanical circulatory support. Methods We aimed to assess outcomes and complications among patients with HIV supported on VA ECMO reported to a multicentre registry and present a case report of a 32 year old male requiring VA ECMO for cardiogenic shock as a consequence of his untreated HIV and acquired immune deficiency syndrome (AIDS). A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry data from 1989 to 2019 was performed in HIV patients supported on VA ECMO. Results 36 HIV positive patients were reported to the ELSO Database who received VA ECMO during the study period with known outcomes. 15 patients (41%) survived to discharge. No significant differences existed between survivors and non-survivors in demographic variables, duration of VA ECMO support or cardiac parameters. Inotrope and/or vasopressor requirement prior to or during VA ECMO support was associated with increased mortality. Survivors were more likely to develop circuit thrombosis. The patient presented was supported on VA ECMO for 14 days and was discharged from hospital day 85. Conclusions A limited number of patients with HIV have been supported with VA ECMO and more data is required to ascertain the indications for ECMO in this population. HIV should not be considered an absolute contraindication to VA ECMO as they may have comparable outcomes to other patient groups requiring VA ECMO support.https://doi.org/10.1186/s13019-023-02191-8Cardiogenic shockExtracorporeal life support (ECLS)Extracorporeal life support Organization (ELSO)Extracorporeal membrane oxygenation (ECMO)Human immunodeficiency virus (HIV)Venoarterial |
| spellingShingle | Matthew Laraghy James McCullough John Gerrard Andrie Stroebel James Winearls Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry Journal of Cardiothoracic Surgery Cardiogenic shock Extracorporeal life support (ECLS) Extracorporeal life support Organization (ELSO) Extracorporeal membrane oxygenation (ECMO) Human immunodeficiency virus (HIV) Venoarterial |
| title | Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry |
| title_full | Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry |
| title_fullStr | Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry |
| title_full_unstemmed | Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry |
| title_short | Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry |
| title_sort | venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus positive patients a case report and review of a multicentre registry |
| topic | Cardiogenic shock Extracorporeal life support (ECLS) Extracorporeal life support Organization (ELSO) Extracorporeal membrane oxygenation (ECMO) Human immunodeficiency virus (HIV) Venoarterial |
| url | https://doi.org/10.1186/s13019-023-02191-8 |
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