| Measurement of end-tidal carbon dioxide in patients with cardiogenic shock treated using a percutaneous cardiopulmonary assist system. | |
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MedLine Citation:
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PMID: 15226606 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We have reported that percutaneous cardiopulmonary assist systems (PCPS) are effective in treating life-threatening cardiogenic shock that is intractable to treatment with intraaortic balloon pumping (IABP). However, there are few clinical indices that can be used to evaluate the effectiveness of PCPS. End-tidal carbon dioxide (ET-CO(2)) content reflects pulmonary blood flow. We monitored ET-CO(2) continuously and determined whether we could use it as a new index to evaluate the effectiveness of PCPS. Seventeen patients with cardiogenic shock were intubated and evaluated by ET-CO(2) monitoring during PCPS. The etiology of shock included acute myocardial infarction (n=10), acute myocarditis (n=2), recent coronary artery bypass graft (n=1), cardiac rupture (n=1), hypertrophic obstructive cardiomyopathy complicated by ventricular fibrillation (n=1), left atrial myxoma (n=1) and artificial valve malfunction (n=1). PCPS was extremely effective in 10 of 17 patients (58.8%), and they recovered from the cardiogenic shock. The remaining 7 patients did not recover from shock, and died during PCPS. Six of ten patients who recovered from shock were successfully weaned from PCPS and 4 patients had good long-term survival. In the cases where PCPS was effective, the ET-CO(2) measured soon after the beginning of PCPS was significantly higher than in the cases in which PCPS was ineffective. Furthermore, the ET-CO(2) content increased gradually with the improvement in hemodynamics. In contrast, ET-CO(2) content remained low if PCPS was not effective. The ET-CO(2) represents a useful predictor of survival or death and is also a good index for weaning in patients treated with PCPS. |
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Authors:
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Keiji Tanaka; Naoki Sato; Takeshi Yamamoto; Koichi Akutsu; Masahiro Fujii; Teruo Takano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of Nihon Medical School = Nihon Ika Daigaku zasshi Volume: 71 ISSN: 1345-4676 ISO Abbreviation: J Nihon Med Sch Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-06-30 Completed Date: 2004-08-31 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 100935589 Medline TA: J Nihon Med Sch Country: Japan |
Other Details:
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Languages: eng Pagination: 160-6 Citation Subset: IM |
Affiliation:
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Division of Intensive and Coronary Care Unit, Nippon Medical School. k-tanaka@nms.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Biological Markers / blood Carbon Dioxide / blood* Cardiopulmonary Bypass / methods* Child Female Humans Male Middle Aged Monitoring, Physiologic Pulmonary Circulation* Retrospective Studies Shock, Cardiogenic / diagnosis*, physiopathology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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