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Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support*

 

作者: Birgit Schwarz,   Peter Mair,   Josef Margreiter,   Andreas Pomaroli,   Christoph Hoermann,   Johannes Bonatti,   Karl Lindner,  

 

期刊: Critical Care Medicine  (OVID Available online 2003)
卷期: Volume 31, issue 3  

页码: 758-764

 

ISSN:0090-3493

 

年代: 2003

 

出版商: OVID

 

关键词: cardiogenic shock;cardiopulmonary arrest;cardiopulmonary bypass;percutaneous;emergency;resuscitation

 

数据来源: OVID

 

摘要:

ObjectiveMechanical circulatory support can maintain vital organ perfusion in patients with cardiac failure unresponsive to standard pharmacologic treatment. The purpose of the current study was to report complication and survival rates in patients supported with emergency percutaneous venoarterial cardiopulmonary bypass because of prolonged cardiogenic shock or cardiopulmonary arrest.DesignRetrospective clinical study.SubjectsA total of 46 patients supported with venoarterial cardiopulmonary bypass, 25 because of cardiogenic shock unresponsive to pharmacologic therapy and 21 because of cardiopulmonary arrest unresponsive to standard advanced cardiac life support.ResultsIn 41 of the 46 patients (89%), stable extracorporeal circulation was established; in five patients (11%), femoral cannulation was accomplished only after a surgical cutdown. A total of 28 patients were weaned from cardiopulmonary bypass (19 of 25 patients with cardiogenic shock vs. 9 of 21 patients with cardiopulmonary arrest,p= .03), and 13 patients had long-term survival (10 of 25 patients with cardiogenic shock vs. 3 of 21 patients with cardiopulmonary arrest,p= .1). Complications directly related to the use of cardiopulmonary bypass were found in 18 patients (39%), major complications related to femoral cannulation being the most common single cause for bypass-associated morbidity (eight patients, 17%)ConclusionsLong-term survival rates after emergency percutaneous cardiopulmonary bypass are encouraging in patients with an underlying cardiocirculatory disease amenable to immediate corrective intervention (angioplasty, surgery, transplantation).

 

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