| Emergent percutaneous cardiopulmonary bypass in patients having cardiovascular collapse in the cardiac catheterization laboratory. | |
MedLine Citation:
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PMID: 8184811 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Percutaneous cardiopulmonary bypass (PCB) was instituted in 30 initially stable patients who developed either cardiac arrest refractory to resuscitation (n = 7) or cardiogenic shock (mean arterial blood pressure < 50 mm Hg unresponsive to fluid resuscitation or vasopressors) (n = 23) after a catheterization laboratory complication. Events leading to collapse included abrupt closure during percutaneous transluminal coronary angioplasty (PTCA) (n = 22), complications from diagnostic cardiac catheterization (n = 6), left ventricular perforation during mitral valvuloplasty (n = 1), and right ventricular perforation during pericardiocentesis (n = 1). PCB was initiated within 20 minutes of cardiovascular collapse in 83% of patients (arrest: 21 +/- 13 minutes [range 10 to 50]; and shock: 17 +/- 6 minutes [range 10 to 30]). Mean arterial blood pressure increased on PCB from 0 to 56 mm Hg in patients with cardiac arrest and from 37 to 63 mm Hg in those with cardiogenic shock at mean PCB flow rates of 2.5 to 5.0 liters/min. Subsequent therapy on PCB included emergent cardiac surgery (n = 14), PTCA (n = 13) and medical therapy (n = 3). Six patients (20%) survived to hospital discharge (3 with cardiac surgery, 2 with PTCA, and 1 with medical therapy). All 7 patients with refractory cardiac arrest died despite further interventions on PCB, whereas 6 of 23 (26%) with cardiogenic shock survived to hospital discharge. Thus, in response to cardiovascular collapse in the catheterization laboratory, PCB does not salvage patients who do not regain a stable cardiac rhythm. PCB can stabilize patients who develop cardiogenic shock for further interventions which are lifesaving in only a minority of patients. |
Authors:
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D W Grambow; G M Deeb; G S Pavlides; A Margulis; W W O'Neill; E R Bates |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 73 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1994 May |
Date Detail:
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Created Date: 1994-06-16 Completed Date: 1994-06-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 872-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0022. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / adverse effects Cardiopulmonary Bypass / adverse effects, methods* Emergencies Female Follow-Up Studies Heart Arrest / etiology, therapy* Heart Catheterization / adverse effects* Humans Male Middle Aged Retrospective Studies Shock, Cardiogenic / etiology, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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