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Introduction <p>Fulminant myocarditis (FM) is a life-threatening condition that may require veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Evidence from Latin America remains limited.</p> Methods <p>We conducted a retrospective case series of adult patients with FM requiring VA-ECMO support at a high-complexity center. Clinical, hemodynamic, metabolic, and echocardiographic variables were analyzed descriptively.</p> Results <p>This case series included 16 patients with a mean age of 39.03 years (SD 12.93), with an equal number of male and female patients. Twenty-eight–day survival was 68.75% (11/16). According to the Charlson Comorbidity Index, 70% (11/16) of the patients had a score of 0. The median survival after veno-arterial ECMO (SAVE) score was 1.5 (interquartile range [IQR] 1–3). Lactate levels and vasoactive-inotropic score (VIS) reduced from 3.79 (IQR: 1.68–8.46) mmoL/L and 68 (IQR: 54–113) pre-ECMO to 1.52 (IQR: 1.26–2.03) mmoL/L and 20 (IQR: 13–45) post-ECMO, respectively. In contrast, PaO₂/FiO₂ ratio, left ventricular ejection fraction, and fractional area change (FAC) increased from 186 (IQR: 126–245) mmHg, 16.5% (IQR: 10%–34%), and 29.5% (IQR: 19–33) pre-ECMO to 260 (IQR: 178–307) mmHg, 51.5% (IQR: 45%–55%), and 42% (IQR: 37–45) post-ECMO, respectively. Complications included renal events in 56.25% (9/16), bleeding 37.5% (6/16), cardiovascular complications in 31.25% (5/16) and infectious complications in 33.33% (5/16) of the participants.</p> Conclusions <p>In this cohort of patients with FM supported with VA-ECMO, changes in hemodynamic, metabolic, and echocardiographic parameters were observed following support initiation, with survival rates comparable to prior reports.</p>

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Veno-arterial ECMO in fulminant myocarditis: a retrospective single-center case series

  • 期刊论文

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  • 发表日期：

    2026年7月1日

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  • Mario Mercado-Díaz,
  • Cesar Quecano-Rosas,
  • Eduardo Tuta-Quintero,
  • Julian Cortes-Salinas,
  • Jenny Garzon-Ruiz,
  • Karen Mercado-Rey,
  • Claudia Poveda-Henao,
  • Henry Robayo-Amortegui

摘要

Introduction

Fulminant myocarditis (FM) is a life-threatening condition that may require veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Evidence from Latin America remains limited.

Methods

We conducted a retrospective case series of adult patients with FM requiring VA-ECMO support at a high-complexity center. Clinical, hemodynamic, metabolic, and echocardiographic variables were analyzed descriptively.

Results

This case series included 16 patients with a mean age of 39.03 years (SD 12.93), with an equal number of male and female patients. Twenty-eight–day survival was 68.75% (11/16). According to the Charlson Comorbidity Index, 70% (11/16) of the patients had a score of 0. The median survival after veno-arterial ECMO (SAVE) score was 1.5 (interquartile range [IQR] 1–3). Lactate levels and vasoactive-inotropic score (VIS) reduced from 3.79 (IQR: 1.68–8.46) mmoL/L and 68 (IQR: 54–113) pre-ECMO to 1.52 (IQR: 1.26–2.03) mmoL/L and 20 (IQR: 13–45) post-ECMO, respectively. In contrast, PaO₂/FiO₂ ratio, left ventricular ejection fraction, and fractional area change (FAC) increased from 186 (IQR: 126–245) mmHg, 16.5% (IQR: 10%–34%), and 29.5% (IQR: 19–33) pre-ECMO to 260 (IQR: 178–307) mmHg, 51.5% (IQR: 45%–55%), and 42% (IQR: 37–45) post-ECMO, respectively. Complications included renal events in 56.25% (9/16), bleeding 37.5% (6/16), cardiovascular complications in 31.25% (5/16) and infectious complications in 33.33% (5/16) of the participants.

Conclusions

In this cohort of patients with FM supported with VA-ECMO, changes in hemodynamic, metabolic, and echocardiographic parameters were observed following support initiation, with survival rates comparable to prior reports.