| Extracorporeal cardiopulmonary support may be an efficient rescue of patients after massive pulmonary embolism. An experimental porcine study. | |
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MedLine Citation:
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PMID: 22316657 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: Treatment of massive pulmonary embolism leading to cardiac arrest is controversial but restitution of circulation within a shorter time is crucial. Cardiopulmonary support and therapeutic hypothermia is an option for cardiac arrest initially of unknown reason. However, hypothermia may influence the effect of the ongoing intrinsic fibrinolysis. OBJECTIVES: To establish a porcine model of massive pulmonary embolism, to show that cardiopulmonary support can rescue pigs with massive pulmonary embolism and to examine the effect of hypothermia on fibrinolysis. METHODS: Pigs ~80kg were anesthetised and prepared for cardiopulmonary support. Repetitive injections of preformed blood thrombi into the right atrium were done until cardiac arrest. Cardiopulmonary support was established and eighteen pigs were randomised into 3 groups: Normothermia (38-39°C); hypothermia (33-34°C); or medication with recombinant tissue plasminogen activator. After three hours the pigs were weaned from cardiopulmonary support, and after 15minutes with spontaneous circulation assassinated and autopsied. Remaining thrombi in the lungs were weighed. RESULTS: The development of fatal pulmonary embolism was highly reproducible. All 18 pigs could be weaned from cardiopulmonary support and survived more than 15minutes. The amount of remaining thromboemboli was substantial in all groups and not significantly different between groups. Normothermic group 20.0±2.2g, Hypothermic group 17.0±3.7g, and rt-PA group 14.3±3.2g. CONCLUSIONS: Cardiopulmonary support could rescue pigs with massive pulmonary embolism. Hypothermia did not reduce the emboli but may for other reasons be beneficial. The optimal additional treatment is still unknown but treatment modalities can be tested in this model. |
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Authors:
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Benedict Kjærgaard; Bodil Steen Rasmussen; Susanne de Neergaard; Lars Hvilsted Rasmussen; Søren Risom Kristensen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-6 |
Journal Detail:
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Title: Thrombosis research Volume: - ISSN: 1879-2472 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Cardiothoracic Surgery, Cardiovascular Research Centre , Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark; Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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