Document Detail


Experience with percutaneous venoarterial cardiopulmonary bypass for emergency circulatory support.
MedLine Citation:
PMID:  12626980     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Mechanical 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. DESIGN: Retrospective clinical study. SUBJECTS: A 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. RESULTS: In 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%). CONCLUSIONS: Long-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).
Authors:
Birgit Schwarz; Peter Mair; Josef Margreiter; Andreas Pomaroli; Christoph Hoermann; Johannes Bonatti; Karl H Lindner
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  31     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-10     Completed Date:  2003-04-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  758-64     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, Leopold Franzens University, School of Medicine, Innsbruck, Austria. Birgit.Schwarz@uibk.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arteriovenous Shunt, Surgical*
Cardiopulmonary Bypass / adverse effects,  instrumentation,  methods*
Emergencies*
Female
Heart Arrest / etiology,  mortality,  therapy*
Hemorrhage / epidemiology,  etiology
Humans
Male
Middle Aged
Monitoring, Physiologic / methods
Morbidity
Patient Selection
Prevalence
Resuscitation / adverse effects,  instrumentation,  methods*
Retrospective Studies
Shock, Cardiogenic / etiology,  mortality,  therapy*
Survival Analysis
Thromboembolism / epidemiology,  etiology
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Crit Care Med. 2003 Mar;31(3):978-80   [PMID:  12627019 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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