ExtraCorporeal Membrane Oxygenation in the Therapy for REfractory Septic Shock With Cardiac Function Under Estimated

Inclusion Criteria10

• Age between 18 and 75 years.
• Patients admitted into ICU and diagnosed as septic shock (sepsis-3.0)13, after adequate fluid resuscitation, high-dose vasoactive drug application \[vasoactive inotropic score (VIS) > 120\] and conventional therapy together with at least one of the following criteria: (1) sustained hypotension \[mean arterial pressure (MAP) < 65 mmHg\]; (2) persistent lactacemia (two consecutive values > 5 mmol/L with at least 30 min interval between samples), with non-decreasing trend on steady doses of inotropes and/or vasopressors; (3) persistent low mixed venous blood oxygen saturation (SvO2) (two consecutive values < 55% with at least 30 min interval between samples), with non-increasing trend on steady doses of inotropes and/or vasopressors. The above condition lasts more than 5 hours.
• Rapidly deteriorating sepsis-induced myocardial impairment is defined by at least one of the following criteria: (1) rapidly deteriorating ventricular function (LVEF < 35%); (2) cardiac index (CI) < 2L/min/m2 (> 3 hr); (3) emerging refractory arrhythmia.
• Informed consent provided by the patient or person with decisional responsibility.
• Presence of active bleeding or anticoagulant contraindications.
• Peripheral artery disease disabling insertion of outflow cannula to femoral artery.
• Irreversible neurological pathology
• Severe underlying condition with lift expectancy less than 1 year.
• Special population, such as pregnancy, acquired immune deficiency syndrome (AIDS).
• Patient included in another interventional clinical trial.